| National Provider Identifier [NPI]: | 1831139880 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | LONG |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 855 MONTGOMERY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761072553 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1583 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 149590 |
| Total Medicare Allowed Amount | 78078.2 |
| Total Medicare Payment Amount | 55092.62 |
| Total Medicare Standardized Payment Amount | 55861.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 643 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1738 |
| Total Drug Medicare AllowedAmount | 796.28 |
| Total Drug Medicare PaymentAmount | 746.06 |
| Total Drug Medicare Standardized Payment Amount | 746.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 147852 |
| Total Medical Medicare Allowed Amount | 77281.92 |
| Total Medical Medicare Payment Amount | 54346.56 |
| Total Medical Medicare Standardized Payment Amount | 55115.63 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 129 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7755 |