| National Provider Identifier [NPI]: | 1689014672 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | BRANDI |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1422 OLD WEISGARBER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379091293 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 660 |
| Number Of Medicare Beneficiaries | 239 |
| Total Submitted Charge Amount | 83027 |
| Total Medicare Allowed Amount | 30959.88 |
| Total Medicare Payment Amount | 22843.5 |
| Total Medicare Standardized Payment Amount | 29706.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 660 |
| Total Drug Medicare AllowedAmount | 252.27 |
| Total Drug Medicare PaymentAmount | 197.86 |
| Total Drug Medicare Standardized Payment Amount | 197.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 536 |
| Number Of Medicare Beneficiaries With Medical Services | 239 |
| Total Medical Submitted Charge Amount | 82367 |
| Total Medical Medicare Allowed Amount | 30707.61 |
| Total Medical Medicare Payment Amount | 22645.64 |
| Total Medical Medicare Standardized Payment Amount | 29508.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 145 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| 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 | 196 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.118 |