| National Provider Identifier [NPI]: | 1184822231 |
| Last Name Of The Provider | CHUNG |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 W ARBOR DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921039001 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 262 |
| Number Of Services | 4455 |
| Number Of Medicare Beneficiaries | 2022 |
| Total Submitted Charge Amount | 912263 |
| Total Medicare Allowed Amount | 176064.8 |
| Total Medicare Payment Amount | 136543.78 |
| Total Medicare Standardized Payment Amount | 135120.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1145 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3435 |
| Total Drug Medicare AllowedAmount | 221.78 |
| Total Drug Medicare PaymentAmount | 173.85 |
| Total Drug Medicare Standardized Payment Amount | 173.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 261 |
| Number Of Medical Services | 3310 |
| Number Of Medicare Beneficiaries With Medical Services | 2022 |
| Total Medical Submitted Charge Amount | 908828 |
| Total Medical Medicare Allowed Amount | 175843.02 |
| Total Medical Medicare Payment Amount | 136369.93 |
| Total Medical Medicare Standardized Payment Amount | 134946.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 321 |
| Number Of Beneficiaries Age 65 to 74 | 541 |
| Number Of Beneficiaries Age 75 to 84 | 631 |
| Number Of Beneficiaries Age Greater 84 | 529 |
| Number Of Female Beneficiaries | 1166 |
| Number Of Male Beneficiaries | 856 |
| Number Of Non Hispanic White Beneficiaries | 1848 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 531 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.3192 |