| National Provider Identifier [NPI]: | 1598751059 |
| Last Name Of The Provider | GONG |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 E SPRUCE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203374 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 5477 |
| Number Of Medicare Beneficiaries | 516 |
| Total Submitted Charge Amount | 506327 |
| Total Medicare Allowed Amount | 216417.23 |
| Total Medicare Payment Amount | 171013.53 |
| Total Medicare Standardized Payment Amount | 166539.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 230 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 4839 |
| Total Drug Medicare AllowedAmount | 4146.81 |
| Total Drug Medicare PaymentAmount | 4027.6 |
| Total Drug Medicare Standardized Payment Amount | 4027.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 5247 |
| Number Of Medicare Beneficiaries With Medical Services | 516 |
| Total Medical Submitted Charge Amount | 501488 |
| Total Medical Medicare Allowed Amount | 212270.42 |
| Total Medical Medicare Payment Amount | 166985.93 |
| Total Medical Medicare Standardized Payment Amount | 162512.14 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 420 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8694 |