| National Provider Identifier [NPI]: | 1174619100 |
| Last Name Of The Provider | SONG |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD FACE |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1468 MONTREAL ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCKER |
| Zip Code Of The Provider | 300846902 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 8382 |
| Number Of Medicare Beneficiaries | 1678 |
| Total Submitted Charge Amount | 1724446.76 |
| Total Medicare Allowed Amount | 727184.95 |
| Total Medicare Payment Amount | 542649.93 |
| Total Medicare Standardized Payment Amount | 548565.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 795 |
| Number Of Medicare Beneficiaries With Drug Services | 198 |
| Total Drug Submitted ChargeAmount | 99012 |
| Total Drug Medicare AllowedAmount | 41927.86 |
| Total Drug Medicare PaymentAmount | 32518.95 |
| Total Drug Medicare Standardized Payment Amount | 32518.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 7587 |
| Number Of Medicare Beneficiaries With Medical Services | 1678 |
| Total Medical Submitted Charge Amount | 1625434.76 |
| Total Medical Medicare Allowed Amount | 685257.09 |
| Total Medical Medicare Payment Amount | 510130.98 |
| Total Medical Medicare Standardized Payment Amount | 516046.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 268 |
| Number Of Beneficiaries Age 65 to 74 | 632 |
| Number Of Beneficiaries Age 75 to 84 | 510 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 933 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | 650 |
| Number Of AsianPacific Islander Beneficiaries | 356 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1028 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 650 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0802 |