| National Provider Identifier [NPI]: | 1033100458 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | CAROLINE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | UPLAND |
| Zip Code Of The Provider | 190133902 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3610 |
| Number Of Medicare Beneficiaries | 1765 |
| Total Submitted Charge Amount | 247171.5 |
| Total Medicare Allowed Amount | 86208.84 |
| Total Medicare Payment Amount | 75626.04 |
| Total Medicare Standardized Payment Amount | 71700.35 |
| 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 | 52 |
| Number Of Medical Services | 3610 |
| Number Of Medicare Beneficiaries With Medical Services | 1765 |
| Total Medical Submitted Charge Amount | 247171.5 |
| Total Medical Medicare Allowed Amount | 86208.84 |
| Total Medical Medicare Payment Amount | 75626.04 |
| Total Medical Medicare Standardized Payment Amount | 71700.35 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 935 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 1666 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 1353 |
| Number Of Black or African American Beneficiaries | 342 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 340 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1168 |