| National Provider Identifier [NPI]: | 1700832136 |
| Last Name Of The Provider | TONG |
| First Name Of The Provider | SAMUEL |
| 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 | 81 HIGHLAND AVE |
| Street Address 2 Of The Provider | COMMONWEALTH RADIOLOGY ASSOCIATES, INC. |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 019702714 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 6996 |
| Number Of Medicare Beneficiaries | 2308 |
| Total Submitted Charge Amount | 604220.12 |
| Total Medicare Allowed Amount | 192623.75 |
| Total Medicare Payment Amount | 146587.81 |
| Total Medicare Standardized Payment Amount | 139309.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3330 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 11250 |
| Total Drug Medicare AllowedAmount | 813.68 |
| Total Drug Medicare PaymentAmount | 637.87 |
| Total Drug Medicare Standardized Payment Amount | 637.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 3666 |
| Number Of Medicare Beneficiaries With Medical Services | 2308 |
| Total Medical Submitted Charge Amount | 592970.12 |
| Total Medical Medicare Allowed Amount | 191810.07 |
| Total Medical Medicare Payment Amount | 145949.94 |
| Total Medical Medicare Standardized Payment Amount | 138671.51 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 604 |
| Number Of Beneficiaries Age 65 to 74 | 873 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 289 |
| Number Of Female Beneficiaries | 1489 |
| Number Of Male Beneficiaries | 819 |
| Number Of Non Hispanic White Beneficiaries | 1937 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 106 |
| Number Of Hispanic Beneficiaries | 203 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1371 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 937 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4963 |