| National Provider Identifier [NPI]: | 1750479754 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | GLENN |
| 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 | 100 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GADSDEN |
| Zip Code Of The Provider | 359031199 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 3475 |
| Number Of Medicare Beneficiaries | 514 |
| Total Submitted Charge Amount | 851017 |
| Total Medicare Allowed Amount | 336357.61 |
| Total Medicare Payment Amount | 247522.39 |
| Total Medicare Standardized Payment Amount | 274845.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 586 |
| Number Of Medicare Beneficiaries With Drug Services | 229 |
| Total Drug Submitted ChargeAmount | 82091 |
| Total Drug Medicare AllowedAmount | 45043.28 |
| Total Drug Medicare PaymentAmount | 34670.03 |
| Total Drug Medicare Standardized Payment Amount | 34670.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 2889 |
| Number Of Medicare Beneficiaries With Medical Services | 514 |
| Total Medical Submitted Charge Amount | 768926 |
| Total Medical Medicare Allowed Amount | 291314.33 |
| Total Medical Medicare Payment Amount | 212852.36 |
| Total Medical Medicare Standardized Payment Amount | 240175.54 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 188 |
| Number Of Non Hispanic White Beneficiaries | 487 |
| 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 | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0479 |