| National Provider Identifier [NPI]: | 1851404859 |
| Last Name Of The Provider | FANGMAN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 959 COX RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GASTONIA |
| Zip Code Of The Provider | 280543420 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 18070 |
| Number Of Medicare Beneficiaries | 5890 |
| Total Submitted Charge Amount | 4211660.1 |
| Total Medicare Allowed Amount | 1477955.11 |
| Total Medicare Payment Amount | 1126176.89 |
| Total Medicare Standardized Payment Amount | 1026493.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 51146.9 |
| Total Drug Medicare AllowedAmount | 20554.57 |
| Total Drug Medicare PaymentAmount | 15232.13 |
| Total Drug Medicare Standardized Payment Amount | 15232.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 17967 |
| Number Of Medicare Beneficiaries With Medical Services | 5890 |
| Total Medical Submitted Charge Amount | 4160513.2 |
| Total Medical Medicare Allowed Amount | 1457400.54 |
| Total Medical Medicare Payment Amount | 1110944.76 |
| Total Medical Medicare Standardized Payment Amount | 1011261.56 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 2679 |
| Number Of Beneficiaries Age 75 to 84 | 2068 |
| Number Of Beneficiaries Age Greater 84 | 824 |
| Number Of Female Beneficiaries | 2803 |
| Number Of Male Beneficiaries | 3087 |
| Number Of Non Hispanic White Beneficiaries | 5751 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5439 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 451 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.003 |