| National Provider Identifier [NPI]: | 1154681906 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23845 HOLMAN HWY |
| Street Address 2 Of The Provider | SUITE 227 |
| City Of The Provider | MONTEREY |
| Zip Code Of The Provider | 939405900 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 2199 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 229122.5 |
| Total Medicare Allowed Amount | 178644.67 |
| Total Medicare Payment Amount | 133116.51 |
| Total Medicare Standardized Payment Amount | 132082.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 546 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 12160 |
| Total Drug Medicare AllowedAmount | 10860.28 |
| Total Drug Medicare PaymentAmount | 8511.38 |
| Total Drug Medicare Standardized Payment Amount | 8511.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 1653 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 216962.5 |
| Total Medical Medicare Allowed Amount | 167784.39 |
| Total Medical Medicare Payment Amount | 124605.13 |
| Total Medical Medicare Standardized Payment Amount | 123570.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 155 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 209 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1757 |