| National Provider Identifier [NPI]: | 1528043585 |
| Last Name Of The Provider | SOSOLIK |
| First Name Of The Provider | RANDOLPH |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1209 BROOK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763015601 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 3463 |
| Number Of Medicare Beneficiaries | 1596 |
| Total Submitted Charge Amount | 277493.64 |
| Total Medicare Allowed Amount | 114805.46 |
| Total Medicare Payment Amount | 89377.97 |
| Total Medicare Standardized Payment Amount | 73547.06 |
| 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 | 29 |
| Number Of Medical Services | 3463 |
| Number Of Medicare Beneficiaries With Medical Services | 1596 |
| Total Medical Submitted Charge Amount | 277493.64 |
| Total Medical Medicare Allowed Amount | 114805.46 |
| Total Medical Medicare Payment Amount | 89377.97 |
| Total Medical Medicare Standardized Payment Amount | 73547.06 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 326 |
| Number Of Beneficiaries Age 65 to 74 | 649 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 906 |
| Number Of Male Beneficiaries | 690 |
| Number Of Non Hispanic White Beneficiaries | 1542 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 384 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4635 |