| National Provider Identifier [NPI]: | 1437200128 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | NATALIE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 SAM PERRY BLVD |
| Street Address 2 Of The Provider | RADIOLOGIC ASSOCIATES OF FREDERICKSBURG |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224014453 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4357 |
| Number Of Medicare Beneficiaries | 1600 |
| Total Submitted Charge Amount | 833611 |
| Total Medicare Allowed Amount | 221470.76 |
| Total Medicare Payment Amount | 188451.39 |
| Total Medicare Standardized Payment Amount | 194919.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1561 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 5528 |
| Total Drug Medicare AllowedAmount | 616.03 |
| Total Drug Medicare PaymentAmount | 451.79 |
| Total Drug Medicare Standardized Payment Amount | 451.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2796 |
| Number Of Medicare Beneficiaries With Medical Services | 1600 |
| Total Medical Submitted Charge Amount | 828083 |
| Total Medical Medicare Allowed Amount | 220854.73 |
| Total Medical Medicare Payment Amount | 187999.6 |
| Total Medical Medicare Standardized Payment Amount | 194467.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 957 |
| Number Of Beneficiaries Age 75 to 84 | 447 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 1469 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 1354 |
| Number Of Black or African American Beneficiaries | 184 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1492 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9056 |