National Provider Identifier [NPI]: |
1821057977 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
994 W JERICHO TPKE |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
SMITHTOWN |
Zip Code Of The Provider |
117873235 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
4205 |
Number Of Medicare Beneficiaries |
852 |
Total Submitted Charge Amount |
2960130 |
Total Medicare Allowed Amount |
972628.91 |
Total Medicare Payment Amount |
750955.7 |
Total Medicare Standardized Payment Amount |
613082.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
800 |
Total Drug Medicare AllowedAmount |
277.83 |
Total Drug Medicare PaymentAmount |
217.82 |
Total Drug Medicare Standardized Payment Amount |
217.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
81 |
Number Of Medical Services |
4184 |
Number Of Medicare Beneficiaries With Medical Services |
852 |
Total Medical Submitted Charge Amount |
2959330 |
Total Medical Medicare Allowed Amount |
972351.08 |
Total Medical Medicare Payment Amount |
750737.88 |
Total Medical Medicare Standardized Payment Amount |
612864.73 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
367 |
Number Of Beneficiaries Age 75 to 84 |
291 |
Number Of Beneficiaries Age Greater 84 |
156 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
464 |
Number Of Non Hispanic White Beneficiaries |
825 |
Number Of Black or African American Beneficiaries |
|
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 |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
822 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1488 |