| National Provider Identifier [NPI]: | 1114905494 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | KALANE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1017 2ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954046608 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3259 |
| Number Of Medicare Beneficiaries | 1385 |
| Total Submitted Charge Amount | 630420 |
| Total Medicare Allowed Amount | 293714.08 |
| Total Medicare Payment Amount | 202813.71 |
| Total Medicare Standardized Payment Amount | 198834.4 |
| 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 | 31 |
| Number Of Medical Services | 3259 |
| Number Of Medicare Beneficiaries With Medical Services | 1385 |
| Total Medical Submitted Charge Amount | 630420 |
| Total Medical Medicare Allowed Amount | 293714.08 |
| Total Medical Medicare Payment Amount | 202813.71 |
| Total Medical Medicare Standardized Payment Amount | 198834.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 622 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 901 |
| Number Of Male Beneficiaries | 484 |
| Number Of Non Hispanic White Beneficiaries | 1208 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0531 |