| National Provider Identifier [NPI]: | 1639199656 |
| Last Name Of The Provider | CHUA |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3111 W BEVERLY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTEBELLO |
| Zip Code Of The Provider | 906402216 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2758 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 194800.2 |
| Total Medicare Allowed Amount | 163613.7 |
| Total Medicare Payment Amount | 126421.83 |
| Total Medicare Standardized Payment Amount | 113730.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1291 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 20310.2 |
| Total Drug Medicare AllowedAmount | 16581.25 |
| Total Drug Medicare PaymentAmount | 13172.79 |
| Total Drug Medicare Standardized Payment Amount | 13172.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1467 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 174490 |
| Total Medical Medicare Allowed Amount | 147032.45 |
| Total Medical Medicare Payment Amount | 113249.04 |
| Total Medical Medicare Standardized Payment Amount | 100557.9 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 90 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 39 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.5367 |