| National Provider Identifier [NPI]: | 1972525194 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11505 PALMBRUSH TRL |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | LAKEWOOD RANCH |
| Zip Code Of The Provider | 342022915 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 5100 |
| Number Of Medicare Beneficiaries | 1798 |
| Total Submitted Charge Amount | 1020734 |
| Total Medicare Allowed Amount | 290710 |
| Total Medicare Payment Amount | 221793.38 |
| Total Medicare Standardized Payment Amount | 153749.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 5100 |
| Number Of Medicare Beneficiaries With Medical Services | 1798 |
| Total Medical Submitted Charge Amount | 1020734 |
| Total Medical Medicare Allowed Amount | 290710 |
| Total Medical Medicare Payment Amount | 221793.38 |
| Total Medical Medicare Standardized Payment Amount | 153749.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 992 |
| Number Of Beneficiaries Age 75 to 84 | 504 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 1034 |
| Number Of Male Beneficiaries | 764 |
| Number Of Non Hispanic White Beneficiaries | 1526 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1546 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 252 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9581 |