National Provider Identifier [NPI]: |
1134204043 |
Last Name Of The Provider |
WONG |
First Name Of The Provider |
SUNNY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 W EMERSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTEREY PARK |
Zip Code Of The Provider |
917541718 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
5510 |
Number Of Medicare Beneficiaries |
545 |
Total Submitted Charge Amount |
517325 |
Total Medicare Allowed Amount |
371739.59 |
Total Medicare Payment Amount |
269138.47 |
Total Medicare Standardized Payment Amount |
261170.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
189 |
Number Of Medicare Beneficiaries With Drug Services |
181 |
Total Drug Submitted ChargeAmount |
7920 |
Total Drug Medicare AllowedAmount |
3376.16 |
Total Drug Medicare PaymentAmount |
3308.27 |
Total Drug Medicare Standardized Payment Amount |
3308.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
5321 |
Number Of Medicare Beneficiaries With Medical Services |
545 |
Total Medical Submitted Charge Amount |
509405 |
Total Medical Medicare Allowed Amount |
368363.43 |
Total Medical Medicare Payment Amount |
265830.2 |
Total Medical Medicare Standardized Payment Amount |
257862.53 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
133 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
53 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
434 |
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
18 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
527 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
33 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5293 |