| National Provider Identifier [NPI]: | 1326047200 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6101 PINE RIDGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341193900 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 8114 |
| Number Of Medicare Beneficiaries | 624 |
| Total Submitted Charge Amount | 574218.82 |
| Total Medicare Allowed Amount | 231581.25 |
| Total Medicare Payment Amount | 171625.88 |
| Total Medicare Standardized Payment Amount | 166097.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6766 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 102752.76 |
| Total Drug Medicare AllowedAmount | 37001.82 |
| Total Drug Medicare PaymentAmount | 28268.22 |
| Total Drug Medicare Standardized Payment Amount | 28268.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1348 |
| Number Of Medicare Beneficiaries With Medical Services | 624 |
| Total Medical Submitted Charge Amount | 471466.06 |
| Total Medical Medicare Allowed Amount | 194579.43 |
| Total Medical Medicare Payment Amount | 143357.66 |
| Total Medical Medicare Standardized Payment Amount | 137828.84 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 313 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 586 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 1.4105 |