| National Provider Identifier [NPI]: | 1760418743 |
| Last Name Of The Provider | CHUNG |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9135 SW BARNES RD |
| Street Address 2 Of The Provider | SUITE 961 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972256646 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2370 |
| Number Of Medicare Beneficiaries | 957 |
| Total Submitted Charge Amount | 712695 |
| Total Medicare Allowed Amount | 278041.72 |
| Total Medicare Payment Amount | 196954.09 |
| Total Medicare Standardized Payment Amount | 196108.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2370 |
| Number Of Medicare Beneficiaries With Medical Services | 957 |
| Total Medical Submitted Charge Amount | 712695 |
| Total Medical Medicare Allowed Amount | 278041.72 |
| Total Medical Medicare Payment Amount | 196954.09 |
| Total Medical Medicare Standardized Payment Amount | 196108.71 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 331 |
| Number Of Beneficiaries Age 75 to 84 | 411 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 576 |
| Number Of Male Beneficiaries | 381 |
| Number Of Non Hispanic White Beneficiaries | 855 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 883 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0044 |