| National Provider Identifier [NPI]: | 1073537072 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | TADRON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 INDIAN LAKE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HENDERSONVILLE |
| Zip Code Of The Provider | 370756214 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 608 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 79767.5 |
| Total Medicare Allowed Amount | 61495.66 |
| Total Medicare Payment Amount | 46617.31 |
| Total Medicare Standardized Payment Amount | 51688.21 |
| 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 | 19 |
| Number Of Medical Services | 608 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 79767.5 |
| Total Medical Medicare Allowed Amount | 61495.66 |
| Total Medical Medicare Payment Amount | 46617.31 |
| Total Medical Medicare Standardized Payment Amount | 51688.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 147 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| Number Of Black or African American Beneficiaries | |
| 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 | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2104 |