| National Provider Identifier [NPI]: | 1831121938 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30 N 1900 E |
| Street Address 2 Of The Provider | ROOM 4A100 SOM |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841320002 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 4517 |
| Number Of Medicare Beneficiaries | 2636 |
| Total Submitted Charge Amount | 509393.5 |
| Total Medicare Allowed Amount | 166844.68 |
| Total Medicare Payment Amount | 125305.22 |
| Total Medicare Standardized Payment Amount | 129684.78 |
| 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 | 48 |
| Number Of Medical Services | 4517 |
| Number Of Medicare Beneficiaries With Medical Services | 2636 |
| Total Medical Submitted Charge Amount | 509393.5 |
| Total Medical Medicare Allowed Amount | 166844.68 |
| Total Medical Medicare Payment Amount | 125305.22 |
| Total Medical Medicare Standardized Payment Amount | 129684.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 477 |
| Number Of Beneficiaries Age 65 to 74 | 1078 |
| Number Of Beneficiaries Age 75 to 84 | 786 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 1260 |
| Number Of Male Beneficiaries | 1376 |
| Number Of Non Hispanic White Beneficiaries | 2278 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 171 |
| Number Of American Indian Alaska Native Beneficiaries | 60 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7359 |