| National Provider Identifier [NPI]: | 1558484717 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | HUMBERTO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ONE HOAG DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 926634162 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 7581 |
| Number Of Medicare Beneficiaries | 3691 |
| Total Submitted Charge Amount | 1082434.28 |
| Total Medicare Allowed Amount | 273493.21 |
| Total Medicare Payment Amount | 205926.41 |
| Total Medicare Standardized Payment Amount | 195404.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1520 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 3220 |
| Total Drug Medicare AllowedAmount | 336.02 |
| Total Drug Medicare PaymentAmount | 263.46 |
| Total Drug Medicare Standardized Payment Amount | 263.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 214 |
| Number Of Medical Services | 6061 |
| Number Of Medicare Beneficiaries With Medical Services | 3691 |
| Total Medical Submitted Charge Amount | 1079214.28 |
| Total Medical Medicare Allowed Amount | 273157.19 |
| Total Medical Medicare Payment Amount | 205662.95 |
| Total Medical Medicare Standardized Payment Amount | 195141.27 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 1380 |
| Number Of Beneficiaries Age 75 to 84 | 1224 |
| Number Of Beneficiaries Age Greater 84 | 826 |
| Number Of Female Beneficiaries | 2085 |
| Number Of Male Beneficiaries | 1606 |
| Number Of Non Hispanic White Beneficiaries | 3079 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 310 |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 97 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3068 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 623 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8084 |