| National Provider Identifier [NPI]: | 1568488203 |
| Last Name Of The Provider | WOLF |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 S 11TH ST |
| Street Address 2 Of The Provider | SUITE 3390 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074824 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 6924 |
| Number Of Medicare Beneficiaries | 1564 |
| Total Submitted Charge Amount | 2208052.26 |
| Total Medicare Allowed Amount | 260750.95 |
| Total Medicare Payment Amount | 197161.25 |
| Total Medicare Standardized Payment Amount | 189696.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4661 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 20559.14 |
| Total Drug Medicare AllowedAmount | 1575.7 |
| Total Drug Medicare PaymentAmount | 1235.23 |
| Total Drug Medicare Standardized Payment Amount | 1235.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 2263 |
| Number Of Medicare Beneficiaries With Medical Services | 1564 |
| Total Medical Submitted Charge Amount | 2187493.12 |
| Total Medical Medicare Allowed Amount | 259175.25 |
| Total Medical Medicare Payment Amount | 195926.02 |
| Total Medical Medicare Standardized Payment Amount | 188461.12 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 365 |
| Number Of Beneficiaries Age 65 to 74 | 647 |
| Number Of Beneficiaries Age 75 to 84 | 380 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 905 |
| Number Of Male Beneficiaries | 659 |
| Number Of Non Hispanic White Beneficiaries | 1113 |
| Number Of Black or African American Beneficiaries | 328 |
| Number Of AsianPacific Islander Beneficiaries | 69 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 417 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 1.691 |