| National Provider Identifier [NPI]: | 1255302097 |
| Last Name Of The Provider | WONG |
| First Name Of The Provider | WILSON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 612 W DUARTE RD |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | ARCADIA |
| Zip Code Of The Provider | 910079220 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 226 |
| Number Of Services | 12922 |
| Number Of Medicare Beneficiaries | 4288 |
| Total Submitted Charge Amount | 1312885.78 |
| Total Medicare Allowed Amount | 386389.5 |
| Total Medicare Payment Amount | 293242.49 |
| Total Medicare Standardized Payment Amount | 266904.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4913 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 1807.6 |
| Total Drug Medicare AllowedAmount | 1199.62 |
| Total Drug Medicare PaymentAmount | 940.56 |
| Total Drug Medicare Standardized Payment Amount | 940.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 222 |
| Number Of Medical Services | 8009 |
| Number Of Medicare Beneficiaries With Medical Services | 4288 |
| Total Medical Submitted Charge Amount | 1311078.18 |
| Total Medical Medicare Allowed Amount | 385189.88 |
| Total Medical Medicare Payment Amount | 292301.93 |
| Total Medical Medicare Standardized Payment Amount | 265963.5 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 475 |
| Number Of Beneficiaries Age 65 to 74 | 1270 |
| Number Of Beneficiaries Age 75 to 84 | 1356 |
| Number Of Beneficiaries Age Greater 84 | 1187 |
| Number Of Female Beneficiaries | 2684 |
| Number Of Male Beneficiaries | 1604 |
| Number Of Non Hispanic White Beneficiaries | 1984 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | 1184 |
| Number Of Hispanic Beneficiaries | 893 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2060 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2228 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3027 |