| National Provider Identifier [NPI]: | 1083678494 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 730 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWTON |
| Zip Code Of The Provider | 67114 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Radiation Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 43979 |
| Number Of Medicare Beneficiaries | 151 |
| Total Submitted Charge Amount | 2333620.1 |
| Total Medicare Allowed Amount | 820182.82 |
| Total Medicare Payment Amount | 639003.8 |
| Total Medicare Standardized Payment Amount | 677959.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 47 |
| Number Of Drug Services | 40334 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 592751.36 |
| Total Drug Medicare AllowedAmount | 191712.53 |
| Total Drug Medicare PaymentAmount | 150302.65 |
| Total Drug Medicare Standardized Payment Amount | 150302.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3645 |
| Number Of Medicare Beneficiaries With Medical Services | 151 |
| Total Medical Submitted Charge Amount | 1740868.74 |
| Total Medical Medicare Allowed Amount | 628470.29 |
| Total Medical Medicare Payment Amount | 488701.15 |
| Total Medical Medicare Standardized Payment Amount | 527656.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 140 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 64 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6641 |