| National Provider Identifier [NPI]: | 1568407377 |
| Last Name Of The Provider | WOLSTAN |
| First Name Of The Provider | BARRY |
| 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 | 23600 TELO AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905054035 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 4574 |
| Number Of Medicare Beneficiaries | 1431 |
| Total Submitted Charge Amount | 1093214 |
| Total Medicare Allowed Amount | 530966.42 |
| Total Medicare Payment Amount | 383653.49 |
| Total Medicare Standardized Payment Amount | 350468.72 |
| 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 | 64 |
| Number Of Medical Services | 4574 |
| Number Of Medicare Beneficiaries With Medical Services | 1431 |
| Total Medical Submitted Charge Amount | 1093214 |
| Total Medical Medicare Allowed Amount | 530966.42 |
| Total Medical Medicare Payment Amount | 383653.49 |
| Total Medical Medicare Standardized Payment Amount | 350468.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 547 |
| Number Of Beneficiaries Age 75 to 84 | 549 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 867 |
| Number Of Male Beneficiaries | 564 |
| Number Of Non Hispanic White Beneficiaries | 1079 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 120 |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1231 |