| National Provider Identifier [NPI]: | 1760542740 |
| Last Name Of The Provider | NINALA |
| First Name Of The Provider | WILKINSON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 344 UNIVERSITY BLVD W |
| Street Address 2 Of The Provider | #113 |
| City Of The Provider | SILVER SPRING |
| Zip Code Of The Provider | 209011948 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1273 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 221210 |
| Total Medicare Allowed Amount | 136100.85 |
| Total Medicare Payment Amount | 95388.18 |
| Total Medicare Standardized Payment Amount | 86235.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 4230 |
| Total Drug Medicare AllowedAmount | 2658.33 |
| Total Drug Medicare PaymentAmount | 2597.67 |
| Total Drug Medicare Standardized Payment Amount | 2597.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1177 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 216980 |
| Total Medical Medicare Allowed Amount | 133442.52 |
| Total Medical Medicare Payment Amount | 92790.51 |
| Total Medical Medicare Standardized Payment Amount | 83638.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 61 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9978 |