| National Provider Identifier [NPI]: | 1497952808 |
| Last Name Of The Provider | WOLF |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2950 OLD SPANISH TRL |
| Street Address 2 Of The Provider | APT 122 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770542227 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 4235 |
| Number Of Medicare Beneficiaries | 2678 |
| Total Submitted Charge Amount | 592473.49 |
| Total Medicare Allowed Amount | 121045.64 |
| Total Medicare Payment Amount | 93266.86 |
| Total Medicare Standardized Payment Amount | 97664.84 |
| 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 | 198 |
| Number Of Medical Services | 4235 |
| Number Of Medicare Beneficiaries With Medical Services | 2678 |
| Total Medical Submitted Charge Amount | 592473.49 |
| Total Medical Medicare Allowed Amount | 121045.64 |
| Total Medical Medicare Payment Amount | 93266.86 |
| Total Medical Medicare Standardized Payment Amount | 97664.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 411 |
| Number Of Beneficiaries Age 65 to 74 | 1077 |
| Number Of Beneficiaries Age 75 to 84 | 820 |
| Number Of Beneficiaries Age Greater 84 | 370 |
| Number Of Female Beneficiaries | 1719 |
| Number Of Male Beneficiaries | 959 |
| Number Of Non Hispanic White Beneficiaries | 2381 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 574 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8115 |