| National Provider Identifier [NPI]: | 1336112473 |
| Last Name Of The Provider | WIKOFF |
| First Name Of The Provider | DONALD |
| 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 | 2915 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARIS |
| Zip Code Of The Provider | 754609360 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 3065 |
| Number Of Medicare Beneficiaries | 629 |
| Total Submitted Charge Amount | 634182.4 |
| Total Medicare Allowed Amount | 252523.99 |
| Total Medicare Payment Amount | 184172.38 |
| Total Medicare Standardized Payment Amount | 196145.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 28390 |
| Total Drug Medicare AllowedAmount | 13880.04 |
| Total Drug Medicare PaymentAmount | 10647.34 |
| Total Drug Medicare Standardized Payment Amount | 10647.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 2868 |
| Number Of Medicare Beneficiaries With Medical Services | 629 |
| Total Medical Submitted Charge Amount | 605792.4 |
| Total Medical Medicare Allowed Amount | 238643.95 |
| Total Medical Medicare Payment Amount | 173525.04 |
| Total Medical Medicare Standardized Payment Amount | 185498.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 477 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | 50 |
| 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 | 513 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2132 |