| National Provider Identifier [NPI]: | 1154527513 |
| Last Name Of The Provider | WILEY |
| First Name Of The Provider | CHERESE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3434 SWISS AVE |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752046251 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 5605 |
| Number Of Medicare Beneficiaries | 322 |
| Total Submitted Charge Amount | 382504.28 |
| Total Medicare Allowed Amount | 153129 |
| Total Medicare Payment Amount | 122734.88 |
| Total Medicare Standardized Payment Amount | 122537.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1900 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 45525 |
| Total Drug Medicare AllowedAmount | 11515.68 |
| Total Drug Medicare PaymentAmount | 9243.71 |
| Total Drug Medicare Standardized Payment Amount | 9243.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 3705 |
| Number Of Medicare Beneficiaries With Medical Services | 322 |
| Total Medical Submitted Charge Amount | 336979.28 |
| Total Medical Medicare Allowed Amount | 141613.32 |
| Total Medical Medicare Payment Amount | 113491.17 |
| Total Medical Medicare Standardized Payment Amount | 113293.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 157 |
| Number Of Black or African American Beneficiaries | 149 |
| 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 | 270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1792 |