| National Provider Identifier [NPI]: | 1962673194 |
| Last Name Of The Provider | CHOI |
| First Name Of The Provider | JEANIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4108 LILLIAN ST |
| Street Address 2 Of The Provider | UNIT B |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770075645 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 1388 |
| Number Of Medicare Beneficiaries | 958 |
| Total Submitted Charge Amount | 425517 |
| Total Medicare Allowed Amount | 79066.95 |
| Total Medicare Payment Amount | 58178.8 |
| Total Medicare Standardized Payment Amount | 60369.6 |
| 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 | 60 |
| Number Of Medical Services | 1388 |
| Number Of Medicare Beneficiaries With Medical Services | 958 |
| Total Medical Submitted Charge Amount | 425517 |
| Total Medical Medicare Allowed Amount | 79066.95 |
| Total Medical Medicare Payment Amount | 58178.8 |
| Total Medical Medicare Standardized Payment Amount | 60369.6 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 333 |
| Number Of Beneficiaries Age 75 to 84 | 254 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 499 |
| Number Of Male Beneficiaries | 459 |
| Number Of Non Hispanic White Beneficiaries | 541 |
| Number Of Black or African American Beneficiaries | 262 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 303 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 40 |
| Average HCC Risk Score Of Beneficiaries | 2.095 |