| National Provider Identifier [NPI]: | 1104885987 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | VIVIEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1481 S KING ST |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | HONOLULU |
| Zip Code Of The Provider | 968142601 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 5822 |
| Number Of Medicare Beneficiaries | 1017 |
| Total Submitted Charge Amount | 437223.07 |
| Total Medicare Allowed Amount | 136315.08 |
| Total Medicare Payment Amount | 100276.63 |
| Total Medicare Standardized Payment Amount | 94458.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4462 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 3236.76 |
| Total Drug Medicare AllowedAmount | 1124.46 |
| Total Drug Medicare PaymentAmount | 771.41 |
| Total Drug Medicare Standardized Payment Amount | 771.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 1360 |
| Number Of Medicare Beneficiaries With Medical Services | 1017 |
| Total Medical Submitted Charge Amount | 433986.31 |
| Total Medical Medicare Allowed Amount | 135190.62 |
| Total Medical Medicare Payment Amount | 99505.22 |
| Total Medical Medicare Standardized Payment Amount | 93686.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 422 |
| Number Of Beneficiaries Age 75 to 84 | 335 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 647 |
| Number Of Male Beneficiaries | 370 |
| Number Of Non Hispanic White Beneficiaries | 177 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 669 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 121 |
| Number Of Beneficiaries With Medicare Only Entitlement | 853 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0822 |