| National Provider Identifier [NPI]: | 1134193493 |
| Last Name Of The Provider | WIELGOLEWSKI |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 SPALDING DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | NAPERVILLE |
| Zip Code Of The Provider | 60540 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Colorectal Surgery (formerly proctology) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 741 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 266713.5 |
| Total Medicare Allowed Amount | 105641.37 |
| Total Medicare Payment Amount | 78927.14 |
| Total Medicare Standardized Payment Amount | 73510.21 |
| 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 | 33 |
| Number Of Medical Services | 741 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 266713.5 |
| Total Medical Medicare Allowed Amount | 105641.37 |
| Total Medical Medicare Payment Amount | 78927.14 |
| Total Medical Medicare Standardized Payment Amount | 73510.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 150 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.934 |