| National Provider Identifier [NPI]: | 1417947250 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | ANDY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MEDICAL DOCTOR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 W CALIFORNIA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911053010 |
| 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 | 183 |
| Number Of Services | 21270 |
| Number Of Medicare Beneficiaries | 2508 |
| Total Submitted Charge Amount | 2391620.68 |
| Total Medicare Allowed Amount | 727476.87 |
| Total Medicare Payment Amount | 555052.44 |
| Total Medicare Standardized Payment Amount | 532771.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 17448 |
| Number Of Medicare Beneficiaries With Drug Services | 192 |
| Total Drug Submitted ChargeAmount | 31948.4 |
| Total Drug Medicare AllowedAmount | 4713.41 |
| Total Drug Medicare PaymentAmount | 3699.68 |
| Total Drug Medicare Standardized Payment Amount | 3699.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 3822 |
| Number Of Medicare Beneficiaries With Medical Services | 2508 |
| Total Medical Submitted Charge Amount | 2359672.28 |
| Total Medical Medicare Allowed Amount | 722763.46 |
| Total Medical Medicare Payment Amount | 551352.76 |
| Total Medical Medicare Standardized Payment Amount | 529071.39 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 322 |
| Number Of Beneficiaries Age 65 to 74 | 890 |
| Number Of Beneficiaries Age 75 to 84 | 788 |
| Number Of Beneficiaries Age Greater 84 | 508 |
| Number Of Female Beneficiaries | 1509 |
| Number Of Male Beneficiaries | 999 |
| Number Of Non Hispanic White Beneficiaries | 1502 |
| Number Of Black or African American Beneficiaries | 243 |
| Number Of AsianPacific Islander Beneficiaries | 255 |
| Number Of Hispanic Beneficiaries | 436 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 919 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9863 |