| National Provider Identifier [NPI]: | 1043218662 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 E ROLLINS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328031248 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 7063 |
| Number Of Medicare Beneficiaries | 3245 |
| Total Submitted Charge Amount | 600715.62 |
| Total Medicare Allowed Amount | 201362.91 |
| Total Medicare Payment Amount | 152221.45 |
| Total Medicare Standardized Payment Amount | 153741.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3048 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1348.79 |
| Total Drug Medicare AllowedAmount | 592.43 |
| Total Drug Medicare PaymentAmount | 434.54 |
| Total Drug Medicare Standardized Payment Amount | 434.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 4015 |
| Number Of Medicare Beneficiaries With Medical Services | 3245 |
| Total Medical Submitted Charge Amount | 599366.83 |
| Total Medical Medicare Allowed Amount | 200770.48 |
| Total Medical Medicare Payment Amount | 151786.91 |
| Total Medical Medicare Standardized Payment Amount | 153306.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 555 |
| Number Of Beneficiaries Age 65 to 74 | 1146 |
| Number Of Beneficiaries Age 75 to 84 | 1000 |
| Number Of Beneficiaries Age Greater 84 | 544 |
| Number Of Female Beneficiaries | 1802 |
| Number Of Male Beneficiaries | 1443 |
| Number Of Non Hispanic White Beneficiaries | 2336 |
| Number Of Black or African American Beneficiaries | 357 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 446 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 865 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4542 |