| National Provider Identifier [NPI]: | 1952508715 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4620 VILLAGE SQUARE DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PADUCAH |
| Zip Code Of The Provider | 420017501 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 6741 |
| Number Of Medicare Beneficiaries | 1583 |
| Total Submitted Charge Amount | 823074 |
| Total Medicare Allowed Amount | 575594.56 |
| Total Medicare Payment Amount | 431758.82 |
| Total Medicare Standardized Payment Amount | 458353.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 387 |
| Number Of Medicare Beneficiaries With Drug Services | 194 |
| Total Drug Submitted ChargeAmount | 7742 |
| Total Drug Medicare AllowedAmount | 3793.27 |
| Total Drug Medicare PaymentAmount | 3393.05 |
| Total Drug Medicare Standardized Payment Amount | 3393.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 6354 |
| Number Of Medicare Beneficiaries With Medical Services | 1583 |
| Total Medical Submitted Charge Amount | 815332 |
| Total Medical Medicare Allowed Amount | 571801.29 |
| Total Medical Medicare Payment Amount | 428365.77 |
| Total Medical Medicare Standardized Payment Amount | 454960.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 316 |
| Number Of Female Beneficiaries | 845 |
| Number Of Male Beneficiaries | 738 |
| Number Of Non Hispanic White Beneficiaries | 1490 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7831 |