| National Provider Identifier [NPI]: | 1548333552 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 198 CANAL STREET |
| Street Address 2 Of The Provider | SUITE 602 |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 10013 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 5739 |
| Number Of Medicare Beneficiaries | 409 |
| Total Submitted Charge Amount | 359129.66 |
| Total Medicare Allowed Amount | 321463.41 |
| Total Medicare Payment Amount | 248263.54 |
| Total Medicare Standardized Payment Amount | 220392.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 439 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 3670.92 |
| Total Drug Medicare AllowedAmount | 1847.25 |
| Total Drug Medicare PaymentAmount | 1721.65 |
| Total Drug Medicare Standardized Payment Amount | 1721.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 5300 |
| Number Of Medicare Beneficiaries With Medical Services | 409 |
| Total Medical Submitted Charge Amount | 355458.74 |
| Total Medical Medicare Allowed Amount | 319616.16 |
| Total Medical Medicare Payment Amount | 246541.89 |
| Total Medical Medicare Standardized Payment Amount | 218670.63 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 51 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 39 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.666 |