| National Provider Identifier [NPI]: | 1619198272 |
| Last Name Of The Provider | SON |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5317 HERITAGE PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | CULVER CITY |
| Zip Code Of The Provider | 902304986 |
| 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 | 166 |
| Number Of Services | 2020 |
| Number Of Medicare Beneficiaries | 530 |
| Total Submitted Charge Amount | 1430772.81 |
| Total Medicare Allowed Amount | 237739.85 |
| Total Medicare Payment Amount | 186253.86 |
| Total Medicare Standardized Payment Amount | 178922.71 |
| 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 | 166 |
| Number Of Medical Services | 2020 |
| Number Of Medicare Beneficiaries With Medical Services | 530 |
| Total Medical Submitted Charge Amount | 1430772.81 |
| Total Medical Medicare Allowed Amount | 237739.85 |
| Total Medical Medicare Payment Amount | 186253.86 |
| Total Medical Medicare Standardized Payment Amount | 178922.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 268 |
| Number Of Non Hispanic White Beneficiaries | 178 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 222 |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 420 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 4.8309 |