| National Provider Identifier [NPI]: | 1467489674 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2125 OAK GROVE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945982536 |
| 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 | 183 |
| Number Of Services | 9250 |
| Number Of Medicare Beneficiaries | 3152 |
| Total Submitted Charge Amount | 1205405 |
| Total Medicare Allowed Amount | 256857.01 |
| Total Medicare Payment Amount | 202334.45 |
| Total Medicare Standardized Payment Amount | 180328.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4410 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 10080 |
| Total Drug Medicare AllowedAmount | 2784.56 |
| Total Drug Medicare PaymentAmount | 2183.16 |
| Total Drug Medicare Standardized Payment Amount | 2183.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 4840 |
| Number Of Medicare Beneficiaries With Medical Services | 3152 |
| Total Medical Submitted Charge Amount | 1195325 |
| Total Medical Medicare Allowed Amount | 254072.45 |
| Total Medical Medicare Payment Amount | 200151.29 |
| Total Medical Medicare Standardized Payment Amount | 178145.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 1316 |
| Number Of Beneficiaries Age 75 to 84 | 825 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 2136 |
| Number Of Male Beneficiaries | 1016 |
| Number Of Non Hispanic White Beneficiaries | 1806 |
| Number Of Black or African American Beneficiaries | 647 |
| Number Of AsianPacific Islander Beneficiaries | 348 |
| Number Of Hispanic Beneficiaries | 257 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2074 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1078 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.75 |