| National Provider Identifier [NPI]: | 1710102231 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | CHUN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 132 S 10TH ST |
| Street Address 2 Of The Provider | MAIN BUILDING, ROOM 1063 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191075244 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 7104 |
| Number Of Medicare Beneficiaries | 1066 |
| Total Submitted Charge Amount | 368003.72 |
| Total Medicare Allowed Amount | 125212 |
| Total Medicare Payment Amount | 94221.02 |
| Total Medicare Standardized Payment Amount | 81758.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5755 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 4197.25 |
| Total Drug Medicare AllowedAmount | 2410.62 |
| Total Drug Medicare PaymentAmount | 1847.93 |
| Total Drug Medicare Standardized Payment Amount | 1847.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 1349 |
| Number Of Medicare Beneficiaries With Medical Services | 1066 |
| Total Medical Submitted Charge Amount | 363806.47 |
| Total Medical Medicare Allowed Amount | 122801.38 |
| Total Medical Medicare Payment Amount | 92373.09 |
| Total Medical Medicare Standardized Payment Amount | 79910.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 328 |
| Number Of Beneficiaries Age 75 to 84 | 320 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 607 |
| Number Of Male Beneficiaries | 459 |
| Number Of Non Hispanic White Beneficiaries | 659 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 199 |
| Number Of Hispanic Beneficiaries | 91 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 721 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2315 |