| National Provider Identifier [NPI]: | 1487674735 |
| Last Name Of The Provider | WOLEK |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 CRESCENT ST |
| Street Address 2 Of The Provider | MIDDLESEX HOSPITAL |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 06457 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 8774 |
| Number Of Medicare Beneficiaries | 3379 |
| Total Submitted Charge Amount | 955646.16 |
| Total Medicare Allowed Amount | 299672.06 |
| Total Medicare Payment Amount | 235708.85 |
| Total Medicare Standardized Payment Amount | 219761.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3170 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 3204.8 |
| Total Drug Medicare AllowedAmount | 1326.8 |
| Total Drug Medicare PaymentAmount | 1040.22 |
| Total Drug Medicare Standardized Payment Amount | 1040.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 5604 |
| Number Of Medicare Beneficiaries With Medical Services | 3379 |
| Total Medical Submitted Charge Amount | 952441.36 |
| Total Medical Medicare Allowed Amount | 298345.26 |
| Total Medical Medicare Payment Amount | 234668.63 |
| Total Medical Medicare Standardized Payment Amount | 218721.2 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 435 |
| Number Of Beneficiaries Age 65 to 74 | 1226 |
| Number Of Beneficiaries Age 75 to 84 | 1021 |
| Number Of Beneficiaries Age Greater 84 | 697 |
| Number Of Female Beneficiaries | 2205 |
| Number Of Male Beneficiaries | 1174 |
| Number Of Non Hispanic White Beneficiaries | 3094 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 890 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3724 |