National Provider Identifier [NPI]: |
1669558821 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
HUNG-KWONG |
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 |
2020 FOREST AVE |
Street Address 2 Of The Provider |
ROOM 8 |
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
951284805 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1765 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
187235 |
Total Medicare Allowed Amount |
131968.39 |
Total Medicare Payment Amount |
104998.3 |
Total Medicare Standardized Payment Amount |
88532.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
257 |
Number Of Medicare Beneficiaries With Drug Services |
164 |
Total Drug Submitted ChargeAmount |
13975 |
Total Drug Medicare AllowedAmount |
8762.32 |
Total Drug Medicare PaymentAmount |
8583.51 |
Total Drug Medicare Standardized Payment Amount |
8583.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
1508 |
Number Of Medicare Beneficiaries With Medical Services |
229 |
Total Medical Submitted Charge Amount |
173260 |
Total Medical Medicare Allowed Amount |
123206.07 |
Total Medical Medicare Payment Amount |
96414.79 |
Total Medical Medicare Standardized Payment Amount |
79949 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
5 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
37 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9743 |