| National Provider Identifier [NPI]: | 1619919305 |
| Last Name Of The Provider | WOLLAK |
| First Name Of The Provider | ISTVAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 SOUTHCREST CIR |
| Street Address 2 Of The Provider | SUITE 212 |
| City Of The Provider | SOUTHAVEN |
| Zip Code Of The Provider | 386716726 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4117 |
| Number Of Medicare Beneficiaries | 1253 |
| Total Submitted Charge Amount | 812765 |
| Total Medicare Allowed Amount | 355410.13 |
| Total Medicare Payment Amount | 271327.92 |
| Total Medicare Standardized Payment Amount | 299504.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 530 |
| Total Drug Medicare AllowedAmount | 414.56 |
| Total Drug Medicare PaymentAmount | 406.22 |
| Total Drug Medicare Standardized Payment Amount | 406.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 4091 |
| Number Of Medicare Beneficiaries With Medical Services | 1253 |
| Total Medical Submitted Charge Amount | 812235 |
| Total Medical Medicare Allowed Amount | 354995.57 |
| Total Medical Medicare Payment Amount | 270921.7 |
| Total Medical Medicare Standardized Payment Amount | 299097.95 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 281 |
| Number Of Beneficiaries Age 65 to 74 | 477 |
| Number Of Beneficiaries Age 75 to 84 | 361 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 703 |
| Number Of Male Beneficiaries | 550 |
| Number Of Non Hispanic White Beneficiaries | 939 |
| Number Of Black or African American Beneficiaries | 294 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 58 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3869 |