| National Provider Identifier [NPI]: | 1043414642 |
| Last Name Of The Provider | WIGINTON |
| First Name Of The Provider | CLARK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 CYPRESS ST |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796015122 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 12251 |
| Number Of Medicare Beneficiaries | 6645 |
| Total Submitted Charge Amount | 1076297 |
| Total Medicare Allowed Amount | 286683.62 |
| Total Medicare Payment Amount | 214438.2 |
| Total Medicare Standardized Payment Amount | 223470.13 |
| 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 | 189 |
| Number Of Medical Services | 12251 |
| Number Of Medicare Beneficiaries With Medical Services | 6645 |
| Total Medical Submitted Charge Amount | 1076297 |
| Total Medical Medicare Allowed Amount | 286683.62 |
| Total Medical Medicare Payment Amount | 214438.2 |
| Total Medical Medicare Standardized Payment Amount | 223470.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1136 |
| Number Of Beneficiaries Age 65 to 74 | 2472 |
| Number Of Beneficiaries Age 75 to 84 | 2030 |
| Number Of Beneficiaries Age Greater 84 | 1007 |
| Number Of Female Beneficiaries | 4026 |
| Number Of Male Beneficiaries | 2619 |
| Number Of Non Hispanic White Beneficiaries | 5496 |
| Number Of Black or African American Beneficiaries | 245 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 828 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4650 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1995 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5596 |