| National Provider Identifier [NPI]: | 1518163773 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | SAMSON |
| 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 | 550 1ST AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100166402 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 4435 |
| Number Of Medicare Beneficiaries | 3033 |
| Total Submitted Charge Amount | 506608.59 |
| Total Medicare Allowed Amount | 189842.44 |
| Total Medicare Payment Amount | 149561.99 |
| Total Medicare Standardized Payment Amount | 151321.83 |
| 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 | 110 |
| Number Of Medical Services | 4435 |
| Number Of Medicare Beneficiaries With Medical Services | 3033 |
| Total Medical Submitted Charge Amount | 506608.59 |
| Total Medical Medicare Allowed Amount | 189842.44 |
| Total Medical Medicare Payment Amount | 149561.99 |
| Total Medical Medicare Standardized Payment Amount | 151321.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 541 |
| Number Of Beneficiaries Age 65 to 74 | 976 |
| Number Of Beneficiaries Age 75 to 84 | 867 |
| Number Of Beneficiaries Age Greater 84 | 649 |
| Number Of Female Beneficiaries | 1888 |
| Number Of Male Beneficiaries | 1145 |
| Number Of Non Hispanic White Beneficiaries | 2254 |
| Number Of Black or African American Beneficiaries | 617 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 760 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.8767 |