| National Provider Identifier [NPI]: | 1730167818 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1707 OSAGE ST |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 223022607 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 4648 |
| Number Of Medicare Beneficiaries | 960 |
| Total Submitted Charge Amount | 1209738.63 |
| Total Medicare Allowed Amount | 357683.71 |
| Total Medicare Payment Amount | 269972.24 |
| Total Medicare Standardized Payment Amount | 248937.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 228 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 296302.52 |
| Total Drug Medicare AllowedAmount | 44381.67 |
| Total Drug Medicare PaymentAmount | 34564.9 |
| Total Drug Medicare Standardized Payment Amount | 34564.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 4420 |
| Number Of Medicare Beneficiaries With Medical Services | 960 |
| Total Medical Submitted Charge Amount | 913436.11 |
| Total Medical Medicare Allowed Amount | 313302.04 |
| Total Medical Medicare Payment Amount | 235407.34 |
| Total Medical Medicare Standardized Payment Amount | 214372.35 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 338 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 747 |
| Number Of Non Hispanic White Beneficiaries | 703 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 846 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3316 |