National Provider Identifier [NPI]: |
1821095233 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
CHING |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6724 5TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKLYN |
Zip Code Of The Provider |
112205418 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
17639 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
272294 |
Total Medicare Allowed Amount |
152927.64 |
Total Medicare Payment Amount |
121069.23 |
Total Medicare Standardized Payment Amount |
111032.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
15287 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
72324 |
Total Drug Medicare AllowedAmount |
45470.81 |
Total Drug Medicare PaymentAmount |
35648.63 |
Total Drug Medicare Standardized Payment Amount |
35648.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
2352 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
199970 |
Total Medical Medicare Allowed Amount |
107456.83 |
Total Medical Medicare Payment Amount |
85420.6 |
Total Medical Medicare Standardized Payment Amount |
75384.32 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
77 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
28 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
48 |
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 |
31 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
32 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0799 |