| National Provider Identifier [NPI]: | 1700843174 |
| Last Name Of The Provider | WOLFSON |
| First Name Of The Provider | BRAD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 E TACHEVAH DR |
| Street Address 2 Of The Provider | STE 2W-101 |
| City Of The Provider | PALM SPRINGS |
| Zip Code Of The Provider | 922625750 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 5428 |
| Number Of Medicare Beneficiaries | 836 |
| Total Submitted Charge Amount | 733376.9 |
| Total Medicare Allowed Amount | 386858.56 |
| Total Medicare Payment Amount | 289406.79 |
| Total Medicare Standardized Payment Amount | 280150.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 454 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 88100 |
| Total Drug Medicare AllowedAmount | 55674.4 |
| Total Drug Medicare PaymentAmount | 42888.46 |
| Total Drug Medicare Standardized Payment Amount | 42888.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 4974 |
| Number Of Medicare Beneficiaries With Medical Services | 836 |
| Total Medical Submitted Charge Amount | 645276.9 |
| Total Medical Medicare Allowed Amount | 331184.16 |
| Total Medical Medicare Payment Amount | 246518.33 |
| Total Medical Medicare Standardized Payment Amount | 237262.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 322 |
| Number Of Beneficiaries Age 75 to 84 | 335 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 676 |
| Number Of Non Hispanic White Beneficiaries | 741 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3108 |