| National Provider Identifier [NPI]: | 1275624942 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 KEARNEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 945382299 |
| 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 | 38 |
| Number Of Services | 585 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 85772 |
| Total Medicare Allowed Amount | 38023.24 |
| Total Medicare Payment Amount | 27827.98 |
| Total Medicare Standardized Payment Amount | 25201.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 11315 |
| Total Drug Medicare AllowedAmount | 4898.55 |
| Total Drug Medicare PaymentAmount | 4069.12 |
| Total Drug Medicare Standardized Payment Amount | 4069.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 314 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 74457 |
| Total Medical Medicare Allowed Amount | 33124.69 |
| Total Medical Medicare Payment Amount | 23758.86 |
| Total Medical Medicare Standardized Payment Amount | 21132.07 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 36 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| 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 | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9123 |