| National Provider Identifier [NPI]: | 1407849284 |
| Last Name Of The Provider | FONG |
| First Name Of The Provider | MINCH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27800 MEDICAL CENTER RD |
| Street Address 2 Of The Provider | #304 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916410 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 219328 |
| Number Of Medicare Beneficiaries | 508 |
| Total Submitted Charge Amount | 6049671.3 |
| Total Medicare Allowed Amount | 3873232.35 |
| Total Medicare Payment Amount | 3020458.96 |
| Total Medicare Standardized Payment Amount | 2929622.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 63 |
| Number Of Drug Services | 201413 |
| Number Of Medicare Beneficiaries With Drug Services | 227 |
| Total Drug Submitted ChargeAmount | 4687162.3 |
| Total Drug Medicare AllowedAmount | 3076712.51 |
| Total Drug Medicare PaymentAmount | 2401619.03 |
| Total Drug Medicare Standardized Payment Amount | 2401619.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 17915 |
| Number Of Medicare Beneficiaries With Medical Services | 508 |
| Total Medical Submitted Charge Amount | 1362509 |
| Total Medical Medicare Allowed Amount | 796519.84 |
| Total Medical Medicare Payment Amount | 618839.93 |
| Total Medical Medicare Standardized Payment Amount | 528003.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 261 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 444 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0401 |