| National Provider Identifier [NPI]: | 1316977168 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7315 E FRONTAGE RD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | OVERLAND PARK |
| Zip Code Of The Provider | 662041654 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 420 |
| Number Of Medicare Beneficiaries | 40 |
| Total Submitted Charge Amount | 41599 |
| Total Medicare Allowed Amount | 24680.55 |
| Total Medicare Payment Amount | 19565.18 |
| Total Medicare Standardized Payment Amount | 20504.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 760 |
| Total Drug Medicare AllowedAmount | 229.82 |
| Total Drug Medicare PaymentAmount | 216.9 |
| Total Drug Medicare Standardized Payment Amount | 216.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 397 |
| Number Of Medicare Beneficiaries With Medical Services | 40 |
| Total Medical Submitted Charge Amount | 40839 |
| Total Medical Medicare Allowed Amount | 24450.73 |
| Total Medical Medicare Payment Amount | 19348.28 |
| Total Medical Medicare Standardized Payment Amount | 20287.61 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 15 |
| Number Of Beneficiaries Age 75 to 84 | 14 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 16 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.18 |