| National Provider Identifier [NPI]: | 1881612901 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | VIRGINIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27100 CHARDON RD |
| Street Address 2 Of The Provider | HARRINGTON HEART & VASCULAR INST |
| City Of The Provider | RICHMOND HTS |
| Zip Code Of The Provider | 441431116 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 1919 |
| Number Of Medicare Beneficiaries | 896 |
| Total Submitted Charge Amount | 1029565 |
| Total Medicare Allowed Amount | 215771.09 |
| Total Medicare Payment Amount | 163800.47 |
| Total Medicare Standardized Payment Amount | 168639.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 1919 |
| Number Of Medicare Beneficiaries With Medical Services | 896 |
| Total Medical Submitted Charge Amount | 1029565 |
| Total Medical Medicare Allowed Amount | 215771.09 |
| Total Medical Medicare Payment Amount | 163800.47 |
| Total Medical Medicare Standardized Payment Amount | 168639.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 266 |
| Number Of Beneficiaries Age 75 to 84 | 259 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 520 |
| Number Of Male Beneficiaries | 376 |
| Number Of Non Hispanic White Beneficiaries | 538 |
| Number Of Black or African American Beneficiaries | 338 |
| 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 | 614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 282 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.0264 |