| National Provider Identifier [NPI]: | 1356315865 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | DOROTHY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 W 24TH ST |
| Street Address 2 Of The Provider | SUITE 26 |
| City Of The Provider | YUMA |
| Zip Code Of The Provider | 853648366 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 6983 |
| Number Of Medicare Beneficiaries | 1042 |
| Total Submitted Charge Amount | 619640 |
| Total Medicare Allowed Amount | 431638.39 |
| Total Medicare Payment Amount | 302605.2 |
| Total Medicare Standardized Payment Amount | 309444.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 1274 |
| Number Of Medicare Beneficiaries With Drug Services | 432 |
| Total Drug Submitted ChargeAmount | 53681 |
| Total Drug Medicare AllowedAmount | 22661.61 |
| Total Drug Medicare PaymentAmount | 19477.02 |
| Total Drug Medicare Standardized Payment Amount | 19477.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 5709 |
| Number Of Medicare Beneficiaries With Medical Services | 1042 |
| Total Medical Submitted Charge Amount | 565959 |
| Total Medical Medicare Allowed Amount | 408976.78 |
| Total Medical Medicare Payment Amount | 283128.18 |
| Total Medical Medicare Standardized Payment Amount | 289967.55 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 399 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 899 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1001 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0813 |