| National Provider Identifier [NPI]: | 1629067244 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 280 |
| Number Of Services | 12792 |
| Number Of Medicare Beneficiaries | 5268 |
| Total Submitted Charge Amount | 1153425.91 |
| Total Medicare Allowed Amount | 338193.58 |
| Total Medicare Payment Amount | 258670.94 |
| Total Medicare Standardized Payment Amount | 263272.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4612 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 9361.02 |
| Total Drug Medicare AllowedAmount | 1152.2 |
| Total Drug Medicare PaymentAmount | 903.29 |
| Total Drug Medicare Standardized Payment Amount | 903.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 276 |
| Number Of Medical Services | 8180 |
| Number Of Medicare Beneficiaries With Medical Services | 5268 |
| Total Medical Submitted Charge Amount | 1144064.89 |
| Total Medical Medicare Allowed Amount | 337041.38 |
| Total Medical Medicare Payment Amount | 257767.65 |
| Total Medical Medicare Standardized Payment Amount | 262369.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 569 |
| Number Of Beneficiaries Age 65 to 74 | 2051 |
| Number Of Beneficiaries Age 75 to 84 | 1702 |
| Number Of Beneficiaries Age Greater 84 | 946 |
| Number Of Female Beneficiaries | 2909 |
| Number Of Male Beneficiaries | 2359 |
| Number Of Non Hispanic White Beneficiaries | 4576 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 308 |
| Number Of American Indian Alaska Native Beneficiaries | 125 |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 672 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8495 |