National Provider Identifier [NPI]: |
1407859226 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3334 CAPITAL MEDICAL BLVD STE 400 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323084470 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
1245 |
Number Of Medicare Beneficiaries |
356 |
Total Submitted Charge Amount |
663315 |
Total Medicare Allowed Amount |
170066.52 |
Total Medicare Payment Amount |
129500.46 |
Total Medicare Standardized Payment Amount |
128699.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
204 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
5551 |
Total Drug Medicare AllowedAmount |
1858.92 |
Total Drug Medicare PaymentAmount |
1443.25 |
Total Drug Medicare Standardized Payment Amount |
1443.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
1041 |
Number Of Medicare Beneficiaries With Medical Services |
356 |
Total Medical Submitted Charge Amount |
657764 |
Total Medical Medicare Allowed Amount |
168207.6 |
Total Medical Medicare Payment Amount |
128057.21 |
Total Medical Medicare Standardized Payment Amount |
127256.49 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
307 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.032 |