| National Provider Identifier [NPI]: | 1740488766 |
| Last Name Of The Provider | WANG-GILLAM |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4921 PARKVIEW PL |
| Street Address 2 Of The Provider | 7TH FLOOR |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101032 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 45177 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 1943227 |
| Total Medicare Allowed Amount | 642381.51 |
| Total Medicare Payment Amount | 494534.44 |
| Total Medicare Standardized Payment Amount | 493957.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 61 |
| Number Of Drug Services | 43339 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 1535259 |
| Total Drug Medicare AllowedAmount | 510745.01 |
| Total Drug Medicare PaymentAmount | 394866.29 |
| Total Drug Medicare Standardized Payment Amount | 394866.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1838 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 407968 |
| Total Medical Medicare Allowed Amount | 131636.5 |
| Total Medical Medicare Payment Amount | 99668.15 |
| Total Medical Medicare Standardized Payment Amount | 99091.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 154 |
| Number Of Non Hispanic White Beneficiaries | 232 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 240 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 41 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 2.586 |