| National Provider Identifier [NPI]: | 1417102021 |
| Last Name Of The Provider | PAN |
| First Name Of The Provider | JUDONG |
| 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 | 505 PARNASSUS AVE |
| Street Address 2 Of The Provider | M-391 |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941432204 |
| 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 | 175 |
| Number Of Services | 5442 |
| Number Of Medicare Beneficiaries | 3066 |
| Total Submitted Charge Amount | 757258 |
| Total Medicare Allowed Amount | 211285.06 |
| Total Medicare Payment Amount | 155054.64 |
| Total Medicare Standardized Payment Amount | 139688.76 |
| 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 | 175 |
| Number Of Medical Services | 5442 |
| Number Of Medicare Beneficiaries With Medical Services | 3066 |
| Total Medical Submitted Charge Amount | 757258 |
| Total Medical Medicare Allowed Amount | 211285.06 |
| Total Medical Medicare Payment Amount | 155054.64 |
| Total Medical Medicare Standardized Payment Amount | 139688.76 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 274 |
| Number Of Beneficiaries Age 65 to 74 | 1070 |
| Number Of Beneficiaries Age 75 to 84 | 1051 |
| Number Of Beneficiaries Age Greater 84 | 671 |
| Number Of Female Beneficiaries | 1941 |
| Number Of Male Beneficiaries | 1125 |
| Number Of Non Hispanic White Beneficiaries | 2238 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 276 |
| Number Of Hispanic Beneficiaries | 397 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 88 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 674 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5307 |