| National Provider Identifier [NPI]: | 1336145036 |
| Last Name Of The Provider | WOLIN |
| First Name Of The Provider | PRESTON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 830 W DIVERSEY PKWY |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606141454 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 538 |
| Number Of Medicare Beneficiaries | 56 |
| Total Submitted Charge Amount | 191924 |
| Total Medicare Allowed Amount | 37191.52 |
| Total Medicare Payment Amount | 27597.09 |
| Total Medicare Standardized Payment Amount | 24672.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 10929 |
| Total Drug Medicare AllowedAmount | 3087.38 |
| Total Drug Medicare PaymentAmount | 2414.33 |
| Total Drug Medicare Standardized Payment Amount | 2414.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 456 |
| Number Of Medicare Beneficiaries With Medical Services | 56 |
| Total Medical Submitted Charge Amount | 180995 |
| Total Medical Medicare Allowed Amount | 34104.14 |
| Total Medical Medicare Payment Amount | 25182.76 |
| Total Medical Medicare Standardized Payment Amount | 22258.66 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 25 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 42 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.5953 |