| National Provider Identifier [NPI]: | 1578588588 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LN |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 6173 |
| Number Of Medicare Beneficiaries | 2718 |
| Total Submitted Charge Amount | 610967.26 |
| Total Medicare Allowed Amount | 158936.04 |
| Total Medicare Payment Amount | 123832.22 |
| Total Medicare Standardized Payment Amount | 122226.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2406 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 7259.87 |
| Total Drug Medicare AllowedAmount | 485.5 |
| Total Drug Medicare PaymentAmount | 380.61 |
| Total Drug Medicare Standardized Payment Amount | 380.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 3767 |
| Number Of Medicare Beneficiaries With Medical Services | 2718 |
| Total Medical Submitted Charge Amount | 603707.39 |
| Total Medical Medicare Allowed Amount | 158450.54 |
| Total Medical Medicare Payment Amount | 123451.61 |
| Total Medical Medicare Standardized Payment Amount | 121845.93 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 601 |
| Number Of Beneficiaries Age 65 to 74 | 1094 |
| Number Of Beneficiaries Age 75 to 84 | 714 |
| Number Of Beneficiaries Age Greater 84 | 309 |
| Number Of Female Beneficiaries | 1540 |
| Number Of Male Beneficiaries | 1178 |
| Number Of Non Hispanic White Beneficiaries | 1872 |
| Number Of Black or African American Beneficiaries | 390 |
| Number Of AsianPacific Islander Beneficiaries | 130 |
| Number Of Hispanic Beneficiaries | 265 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1940 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 778 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.0875 |