| National Provider Identifier [NPI]: | 1205803053 |
| Last Name Of The Provider | DONG |
| First Name Of The Provider | JINWEN |
| 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 | 210 N BELLE MEAD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST SETAUKET |
| Zip Code Of The Provider | 117333522 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 3557 |
| Number Of Medicare Beneficiaries | 1556 |
| Total Submitted Charge Amount | 1023853 |
| Total Medicare Allowed Amount | 350662.11 |
| Total Medicare Payment Amount | 259273.07 |
| Total Medicare Standardized Payment Amount | 231169.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 275 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 11748 |
| Total Drug Medicare AllowedAmount | 10583.9 |
| Total Drug Medicare PaymentAmount | 7897.07 |
| Total Drug Medicare Standardized Payment Amount | 7897.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3282 |
| Number Of Medicare Beneficiaries With Medical Services | 1555 |
| Total Medical Submitted Charge Amount | 1012105 |
| Total Medical Medicare Allowed Amount | 340078.21 |
| Total Medical Medicare Payment Amount | 251376 |
| Total Medical Medicare Standardized Payment Amount | 223272.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 602 |
| Number Of Beneficiaries Age 75 to 84 | 463 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 850 |
| Number Of Male Beneficiaries | 706 |
| Number Of Non Hispanic White Beneficiaries | 1404 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 288 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6949 |