| National Provider Identifier [NPI]: | 1740388891 |
| Last Name Of The Provider | KONG |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3808 W RIVERSIDE DR |
| Street Address 2 Of The Provider | SUITE 406 |
| City Of The Provider | BURBANK |
| Zip Code Of The Provider | 915054325 |
| 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 | 25 |
| Number Of Services | 1586 |
| Number Of Medicare Beneficiaries | 458 |
| Total Submitted Charge Amount | 318212.17 |
| Total Medicare Allowed Amount | 190703.35 |
| Total Medicare Payment Amount | 147957.65 |
| Total Medicare Standardized Payment Amount | 139716.48 |
| 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 | 25 |
| Number Of Medical Services | 1586 |
| Number Of Medicare Beneficiaries With Medical Services | 458 |
| Total Medical Submitted Charge Amount | 318212.17 |
| Total Medical Medicare Allowed Amount | 190703.35 |
| Total Medical Medicare Payment Amount | 147957.65 |
| Total Medical Medicare Standardized Payment Amount | 139716.48 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 267 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.0916 |