National Provider Identifier [NPI]: |
1255508131 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9500 STOCKDALE HWY |
Street Address 2 Of The Provider |
SUITE #109 |
City Of The Provider |
BAKERSFIELD |
Zip Code Of The Provider |
933113620 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
761 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
183822 |
Total Medicare Allowed Amount |
80130.12 |
Total Medicare Payment Amount |
60142.97 |
Total Medicare Standardized Payment Amount |
55299.71 |
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 |
70 |
Number Of Medical Services |
761 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
183822 |
Total Medical Medicare Allowed Amount |
80130.12 |
Total Medical Medicare Payment Amount |
60142.97 |
Total Medical Medicare Standardized Payment Amount |
55299.71 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
132 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5942 |