| National Provider Identifier [NPI]: | 1053369124 |
| Last Name Of The Provider | CHEN |
| First Name Of The Provider | MERI |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST |
| Street Address 2 Of The Provider | SUITE 456 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123841 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 39790 |
| Number Of Medicare Beneficiaries | 2363 |
| Total Submitted Charge Amount | 1843868 |
| Total Medicare Allowed Amount | 289986.39 |
| Total Medicare Payment Amount | 220720.52 |
| Total Medicare Standardized Payment Amount | 226982.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 36026 |
| Number Of Medicare Beneficiaries With Drug Services | 300 |
| Total Drug Submitted ChargeAmount | 148352 |
| Total Drug Medicare AllowedAmount | 8314.87 |
| Total Drug Medicare PaymentAmount | 6400.3 |
| Total Drug Medicare Standardized Payment Amount | 6400.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 3764 |
| Number Of Medicare Beneficiaries With Medical Services | 2360 |
| Total Medical Submitted Charge Amount | 1695516 |
| Total Medical Medicare Allowed Amount | 281671.52 |
| Total Medical Medicare Payment Amount | 214320.22 |
| Total Medical Medicare Standardized Payment Amount | 220582.39 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 601 |
| Number Of Beneficiaries Age 65 to 74 | 925 |
| Number Of Beneficiaries Age 75 to 84 | 620 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 1366 |
| Number Of Male Beneficiaries | 997 |
| Number Of Non Hispanic White Beneficiaries | 978 |
| Number Of Black or African American Beneficiaries | 942 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 343 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1405 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 958 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4545 |