| National Provider Identifier [NPI]: | 1962669515 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | CONNER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2610 N ALEXANDER DR |
| Street Address 2 Of The Provider | STE 205 |
| City Of The Provider | BAYTOWN |
| Zip Code Of The Provider | 775203368 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 9183 |
| Number Of Medicare Beneficiaries | 1493 |
| Total Submitted Charge Amount | 515770.71 |
| Total Medicare Allowed Amount | 494650.83 |
| Total Medicare Payment Amount | 360518.46 |
| Total Medicare Standardized Payment Amount | 363021.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 25.48 |
| Total Drug Medicare AllowedAmount | 25 |
| Total Drug Medicare PaymentAmount | 19.58 |
| Total Drug Medicare Standardized Payment Amount | 19.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 9169 |
| Number Of Medicare Beneficiaries With Medical Services | 1493 |
| Total Medical Submitted Charge Amount | 515745.23 |
| Total Medical Medicare Allowed Amount | 494625.83 |
| Total Medical Medicare Payment Amount | 360498.88 |
| Total Medical Medicare Standardized Payment Amount | 363001.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 658 |
| Number Of Beneficiaries Age 75 to 84 | 497 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 701 |
| Number Of Male Beneficiaries | 792 |
| Number Of Non Hispanic White Beneficiaries | 1399 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0873 |