| National Provider Identifier [NPI]: | 1679801559 |
| Last Name Of The Provider | FANG |
| First Name Of The Provider | TZANWEI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 369 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 18 |
| City Of The Provider | EAST ISLIP |
| Zip Code Of The Provider | 117302800 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 36254 |
| Number Of Medicare Beneficiaries | 1050 |
| Total Submitted Charge Amount | 1190803.8 |
| Total Medicare Allowed Amount | 347205.59 |
| Total Medicare Payment Amount | 268863.58 |
| Total Medicare Standardized Payment Amount | 233690.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 33876 |
| Number Of Medicare Beneficiaries With Drug Services | 331 |
| Total Drug Submitted ChargeAmount | 9776.8 |
| Total Drug Medicare AllowedAmount | 6137.62 |
| Total Drug Medicare PaymentAmount | 4734.53 |
| Total Drug Medicare Standardized Payment Amount | 4734.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 2378 |
| Number Of Medicare Beneficiaries With Medical Services | 1050 |
| Total Medical Submitted Charge Amount | 1181027 |
| Total Medical Medicare Allowed Amount | 341067.97 |
| Total Medical Medicare Payment Amount | 264129.05 |
| Total Medical Medicare Standardized Payment Amount | 228956.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 349 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 658 |
| Number Of Male Beneficiaries | 392 |
| Number Of Non Hispanic White Beneficiaries | 916 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 945 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2993 |