| National Provider Identifier [NPI]: | 1376511063 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | L |
| 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 | SUITE 101 |
| 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 | 64 |
| Number Of Services | 7083 |
| Number Of Medicare Beneficiaries | 992 |
| Total Submitted Charge Amount | 490317.5 |
| Total Medicare Allowed Amount | 341445.08 |
| Total Medicare Payment Amount | 235967.71 |
| Total Medicare Standardized Payment Amount | 257368.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 597 |
| Number Of Medicare Beneficiaries With Drug Services | 368 |
| Total Drug Submitted ChargeAmount | 16694.5 |
| Total Drug Medicare AllowedAmount | 7024.12 |
| Total Drug Medicare PaymentAmount | 6586.47 |
| Total Drug Medicare Standardized Payment Amount | 6586.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 6486 |
| Number Of Medicare Beneficiaries With Medical Services | 992 |
| Total Medical Submitted Charge Amount | 473623 |
| Total Medical Medicare Allowed Amount | 334420.96 |
| Total Medical Medicare Payment Amount | 229381.24 |
| Total Medical Medicare Standardized Payment Amount | 250781.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 209 |
| Number Of Female Beneficiaries | 549 |
| Number Of Male Beneficiaries | 443 |
| Number Of Non Hispanic White Beneficiaries | 950 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 898 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3123 |