| National Provider Identifier [NPI]: | 1275658734 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 5302 |
| Number Of Medicare Beneficiaries | 2307 |
| Total Submitted Charge Amount | 625993.97 |
| Total Medicare Allowed Amount | 155101.08 |
| Total Medicare Payment Amount | 114806.29 |
| Total Medicare Standardized Payment Amount | 116439.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2282 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 4808.5 |
| Total Drug Medicare AllowedAmount | 1159.28 |
| Total Drug Medicare PaymentAmount | 859.34 |
| Total Drug Medicare Standardized Payment Amount | 859.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 3020 |
| Number Of Medicare Beneficiaries With Medical Services | 2306 |
| Total Medical Submitted Charge Amount | 621185.47 |
| Total Medical Medicare Allowed Amount | 153941.8 |
| Total Medical Medicare Payment Amount | 113946.95 |
| Total Medical Medicare Standardized Payment Amount | 115579.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 446 |
| Number Of Beneficiaries Age 65 to 74 | 832 |
| Number Of Beneficiaries Age 75 to 84 | 655 |
| Number Of Beneficiaries Age Greater 84 | 374 |
| Number Of Female Beneficiaries | 1382 |
| Number Of Male Beneficiaries | 925 |
| Number Of Non Hispanic White Beneficiaries | 1844 |
| Number Of Black or African American Beneficiaries | 157 |
| Number Of AsianPacific Islander Beneficiaries | 146 |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 44 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1690 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 617 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5734 |