| National Provider Identifier [NPI]: | 1932124518 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | CHUNG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1411 E 31ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946021018 |
| 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 | 118 |
| Number Of Services | 2209 |
| Number Of Medicare Beneficiaries | 1295 |
| Total Submitted Charge Amount | 795487 |
| Total Medicare Allowed Amount | 64834.76 |
| Total Medicare Payment Amount | 49299.57 |
| Total Medicare Standardized Payment Amount | 45976.64 |
| 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 | 118 |
| Number Of Medical Services | 2209 |
| Number Of Medicare Beneficiaries With Medical Services | 1295 |
| Total Medical Submitted Charge Amount | 795487 |
| Total Medical Medicare Allowed Amount | 64834.76 |
| Total Medical Medicare Payment Amount | 49299.57 |
| Total Medical Medicare Standardized Payment Amount | 45976.64 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 469 |
| Number Of Beneficiaries Age 65 to 74 | 529 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 561 |
| Number Of Non Hispanic White Beneficiaries | 273 |
| Number Of Black or African American Beneficiaries | 594 |
| Number Of AsianPacific Islander Beneficiaries | 199 |
| Number Of Hispanic Beneficiaries | 197 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1029 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.549 |