National Provider Identifier [NPI]: |
1760421473 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2220 EDWARD HOLLAND DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232302519 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
70288 |
Total Medicare Allowed Amount |
23275.37 |
Total Medicare Payment Amount |
18247.4 |
Total Medicare Standardized Payment Amount |
18604.98 |
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 |
4 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
70288 |
Total Medical Medicare Allowed Amount |
23275.37 |
Total Medical Medicare Payment Amount |
18247.4 |
Total Medical Medicare Standardized Payment Amount |
18604.98 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
54 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
3.8894 |