| National Provider Identifier [NPI]: | 1134251457 |
| Last Name Of The Provider | WONG-LIANG |
| First Name Of The Provider | EIRENE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PH.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8323 SOUTHWEST FWY |
| Street Address 2 Of The Provider | STE 760 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770741609 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Clinical Psychologist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1631 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 245580 |
| Total Medicare Allowed Amount | 140798.09 |
| Total Medicare Payment Amount | 109941.93 |
| Total Medicare Standardized Payment Amount | 86389.09 |
| 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 | 9 |
| Number Of Medical Services | 1631 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 245580 |
| Total Medical Medicare Allowed Amount | 140798.09 |
| Total Medical Medicare Payment Amount | 109941.93 |
| Total Medical Medicare Standardized Payment Amount | 86389.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 103 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 51 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 42 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 3.0398 |