| National Provider Identifier [NPI]: | 1689618209 |
| Last Name Of The Provider | VELLING |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ONE HOAG DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 926634162 |
| 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 | 251 |
| Number Of Services | 2572 |
| Number Of Medicare Beneficiaries | 1355 |
| Total Submitted Charge Amount | 875165.57 |
| Total Medicare Allowed Amount | 219106.13 |
| Total Medicare Payment Amount | 169627.5 |
| Total Medicare Standardized Payment Amount | 157568.77 |
| 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 | 251 |
| Number Of Medical Services | 2572 |
| Number Of Medicare Beneficiaries With Medical Services | 1355 |
| Total Medical Submitted Charge Amount | 875165.57 |
| Total Medical Medicare Allowed Amount | 219106.13 |
| Total Medical Medicare Payment Amount | 169627.5 |
| Total Medical Medicare Standardized Payment Amount | 157568.77 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 454 |
| Number Of Beneficiaries Age 75 to 84 | 467 |
| Number Of Beneficiaries Age Greater 84 | 329 |
| Number Of Female Beneficiaries | 714 |
| Number Of Male Beneficiaries | 641 |
| Number Of Non Hispanic White Beneficiaries | 1152 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 95 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1092 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2138 |