| National Provider Identifier [NPI]: | 1851440127 |
| Last Name Of The Provider | NA |
| First Name Of The Provider | SONG |
| 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 | 4995 FRIENDSHIP RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | BUFORD |
| Zip Code Of The Provider | 305181741 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3614 |
| Number Of Medicare Beneficiaries | 512 |
| Total Submitted Charge Amount | 433180.62 |
| Total Medicare Allowed Amount | 240395.76 |
| Total Medicare Payment Amount | 167056.83 |
| Total Medicare Standardized Payment Amount | 180580.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 591 |
| Number Of Medicare Beneficiaries With Drug Services | 284 |
| Total Drug Submitted ChargeAmount | 13185 |
| Total Drug Medicare AllowedAmount | 2909.39 |
| Total Drug Medicare PaymentAmount | 2757.58 |
| Total Drug Medicare Standardized Payment Amount | 2757.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 3023 |
| Number Of Medicare Beneficiaries With Medical Services | 512 |
| Total Medical Submitted Charge Amount | 419995.62 |
| Total Medical Medicare Allowed Amount | 237486.37 |
| Total Medical Medicare Payment Amount | 164299.25 |
| Total Medical Medicare Standardized Payment Amount | 177823.11 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 446 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 442 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0793 |