| National Provider Identifier [NPI]: | 1528049376 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | KAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PHD MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1401 BONE CREEK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANDUSKY |
| Zip Code Of The Provider | 448707267 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 4934 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 1001138 |
| Total Medicare Allowed Amount | 365073.16 |
| Total Medicare Payment Amount | 271831.14 |
| Total Medicare Standardized Payment Amount | 284675.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1796 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 60350.5 |
| Total Drug Medicare AllowedAmount | 24008.11 |
| Total Drug Medicare PaymentAmount | 18011.37 |
| Total Drug Medicare Standardized Payment Amount | 18011.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 3138 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 940787.5 |
| Total Medical Medicare Allowed Amount | 341065.05 |
| Total Medical Medicare Payment Amount | 253819.77 |
| Total Medical Medicare Standardized Payment Amount | 266663.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 615 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 597 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1446 |