| National Provider Identifier [NPI]: | 1225126386 |
| Last Name Of The Provider | KONG |
| First Name Of The Provider | VICTORIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 S STATE STREET |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 199013530 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 4185 |
| Number Of Medicare Beneficiaries | 2565 |
| Total Submitted Charge Amount | 563619 |
| Total Medicare Allowed Amount | 135834.95 |
| Total Medicare Payment Amount | 105503.76 |
| Total Medicare Standardized Payment Amount | 105561.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 159 |
| Number Of Medical Services | 4185 |
| Number Of Medicare Beneficiaries With Medical Services | 2565 |
| Total Medical Submitted Charge Amount | 563619 |
| Total Medical Medicare Allowed Amount | 135834.95 |
| Total Medical Medicare Payment Amount | 105503.76 |
| Total Medical Medicare Standardized Payment Amount | 105561.65 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 562 |
| Number Of Beneficiaries Age 65 to 74 | 1081 |
| Number Of Beneficiaries Age 75 to 84 | 654 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 1698 |
| Number Of Male Beneficiaries | 867 |
| Number Of Non Hispanic White Beneficiaries | 1916 |
| Number Of Black or African American Beneficiaries | 553 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1861 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 704 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6615 |