| National Provider Identifier [NPI]: | 1649457235 |
| Last Name Of The Provider | WANK |
| First Name Of The Provider | ROSS |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 132 S. 10TH STREET |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY 1087 MAIN BLDG. |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191075244 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 9130 |
| Number Of Medicare Beneficiaries | 4131 |
| Total Submitted Charge Amount | 1049064.43 |
| Total Medicare Allowed Amount | 236909.5 |
| Total Medicare Payment Amount | 183821.29 |
| Total Medicare Standardized Payment Amount | 165434.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 9130 |
| Number Of Medicare Beneficiaries With Medical Services | 4131 |
| Total Medical Submitted Charge Amount | 1049064.43 |
| Total Medical Medicare Allowed Amount | 236909.5 |
| Total Medical Medicare Payment Amount | 183821.29 |
| Total Medical Medicare Standardized Payment Amount | 165434.85 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 981 |
| Number Of Beneficiaries Age 75 to 84 | 1348 |
| Number Of Beneficiaries Age Greater 84 | 1389 |
| Number Of Female Beneficiaries | 2447 |
| Number Of Male Beneficiaries | 1684 |
| Number Of Non Hispanic White Beneficiaries | 3665 |
| Number Of Black or African American Beneficiaries | 205 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 888 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9417 |