| National Provider Identifier [NPI]: | 1699755934 |
| Last Name Of The Provider | WANG |
| First Name Of The Provider | GRANT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2850 TELEGRAPH AVE |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | BERKELEY |
| Zip Code Of The Provider | 947051192 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1447 |
| Number Of Medicare Beneficiaries | 408 |
| Total Submitted Charge Amount | 300477 |
| Total Medicare Allowed Amount | 110247.3 |
| Total Medicare Payment Amount | 81207.75 |
| Total Medicare Standardized Payment Amount | 72201.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 198 |
| Total Drug Submitted ChargeAmount | 20708 |
| Total Drug Medicare AllowedAmount | 8842.03 |
| Total Drug Medicare PaymentAmount | 8646.69 |
| Total Drug Medicare Standardized Payment Amount | 8646.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1187 |
| Number Of Medicare Beneficiaries With Medical Services | 408 |
| Total Medical Submitted Charge Amount | 279769 |
| Total Medical Medicare Allowed Amount | 101405.27 |
| Total Medical Medicare Payment Amount | 72561.06 |
| Total Medical Medicare Standardized Payment Amount | 63554.46 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 241 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0472 |