| National Provider Identifier [NPI]: | 1104017169 |
| Last Name Of The Provider | HU |
| First Name Of The Provider | PHONG |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10666 N TORREY PINES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371027 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 3892 |
| Number Of Medicare Beneficiaries | 1470 |
| Total Submitted Charge Amount | 964325.3 |
| Total Medicare Allowed Amount | 299778.75 |
| Total Medicare Payment Amount | 224818.51 |
| Total Medicare Standardized Payment Amount | 217572.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1046 |
| Number Of Medicare Beneficiaries With Drug Services | 198 |
| Total Drug Submitted ChargeAmount | 83488.8 |
| Total Drug Medicare AllowedAmount | 32860.5 |
| Total Drug Medicare PaymentAmount | 25637.7 |
| Total Drug Medicare Standardized Payment Amount | 25637.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2846 |
| Number Of Medicare Beneficiaries With Medical Services | 1468 |
| Total Medical Submitted Charge Amount | 880836.5 |
| Total Medical Medicare Allowed Amount | 266918.25 |
| Total Medical Medicare Payment Amount | 199180.81 |
| Total Medical Medicare Standardized Payment Amount | 191934.6 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 652 |
| Number Of Beneficiaries Age 75 to 84 | 470 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 671 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 1235 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 95 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4623 |