| National Provider Identifier [NPI]: | 1043290281 |
| Last Name Of The Provider | WAN |
| First Name Of The Provider | SUN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 257 E CENTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 060405214 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 5219 |
| Number Of Medicare Beneficiaries | 1305 |
| Total Submitted Charge Amount | 1185060 |
| Total Medicare Allowed Amount | 557579.51 |
| Total Medicare Payment Amount | 428718.22 |
| Total Medicare Standardized Payment Amount | 400743.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 394 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 27240 |
| Total Drug Medicare AllowedAmount | 18737.51 |
| Total Drug Medicare PaymentAmount | 14690.05 |
| Total Drug Medicare Standardized Payment Amount | 14690.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 4825 |
| Number Of Medicare Beneficiaries With Medical Services | 1305 |
| Total Medical Submitted Charge Amount | 1157820 |
| Total Medical Medicare Allowed Amount | 538842 |
| Total Medical Medicare Payment Amount | 414028.17 |
| Total Medical Medicare Standardized Payment Amount | 386053.08 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 192 |
| Number Of Beneficiaries Age 65 to 74 | 343 |
| Number Of Beneficiaries Age 75 to 84 | 404 |
| Number Of Beneficiaries Age Greater 84 | 366 |
| Number Of Female Beneficiaries | 741 |
| Number Of Male Beneficiaries | 564 |
| Number Of Non Hispanic White Beneficiaries | 1166 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 853 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 452 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6582 |