| National Provider Identifier [NPI]: | 1841236619 |
| Last Name Of The Provider | WILSDORF |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 SPRINGHILL AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366041407 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 7870 |
| Number Of Medicare Beneficiaries | 1741 |
| Total Submitted Charge Amount | 951967 |
| Total Medicare Allowed Amount | 431213.48 |
| Total Medicare Payment Amount | 324949.37 |
| Total Medicare Standardized Payment Amount | 352848.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 235 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 15746 |
| Total Drug Medicare AllowedAmount | 11922.58 |
| Total Drug Medicare PaymentAmount | 9287.09 |
| Total Drug Medicare Standardized Payment Amount | 9287.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 7635 |
| Number Of Medicare Beneficiaries With Medical Services | 1741 |
| Total Medical Submitted Charge Amount | 936221 |
| Total Medical Medicare Allowed Amount | 419290.9 |
| Total Medical Medicare Payment Amount | 315662.28 |
| Total Medical Medicare Standardized Payment Amount | 343561.12 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 616 |
| Number Of Beneficiaries Age 75 to 84 | 605 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 862 |
| Number Of Male Beneficiaries | 879 |
| Number Of Non Hispanic White Beneficiaries | 1209 |
| Number Of Black or African American Beneficiaries | 498 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7 |