| National Provider Identifier [NPI]: | 1497793509 |
| Last Name Of The Provider | WILFONG |
| First Name Of The Provider | LALAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8220 WALNUT HILL LN |
| Street Address 2 Of The Provider | SUITE 700, PROFESSIONAL BUILDING II |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752314427 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 97808 |
| Number Of Medicare Beneficiaries | 463 |
| Total Submitted Charge Amount | 5726599 |
| Total Medicare Allowed Amount | 1745447.87 |
| Total Medicare Payment Amount | 1370226.54 |
| Total Medicare Standardized Payment Amount | 1366460.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 58 |
| Number Of Drug Services | 90430 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 4630880 |
| Total Drug Medicare AllowedAmount | 1406025.91 |
| Total Drug Medicare PaymentAmount | 1101625.8 |
| Total Drug Medicare Standardized Payment Amount | 1101625.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 7378 |
| Number Of Medicare Beneficiaries With Medical Services | 463 |
| Total Medical Submitted Charge Amount | 1095719 |
| Total Medical Medicare Allowed Amount | 339421.96 |
| Total Medical Medicare Payment Amount | 268600.74 |
| Total Medical Medicare Standardized Payment Amount | 264834.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 271 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 441 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.611 |