| National Provider Identifier [NPI]: | 1194827337 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6624 FANNIN |
| Street Address 2 Of The Provider | #2480 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770302309 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3485 |
| Number Of Medicare Beneficiaries | 1725 |
| Total Submitted Charge Amount | 561400 |
| Total Medicare Allowed Amount | 169891.89 |
| Total Medicare Payment Amount | 125994.94 |
| Total Medicare Standardized Payment Amount | 128178.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 21697 |
| Total Drug Medicare AllowedAmount | 2174.62 |
| Total Drug Medicare PaymentAmount | 1704.89 |
| Total Drug Medicare Standardized Payment Amount | 1704.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 3444 |
| Number Of Medicare Beneficiaries With Medical Services | 1725 |
| Total Medical Submitted Charge Amount | 539703 |
| Total Medical Medicare Allowed Amount | 167717.27 |
| Total Medical Medicare Payment Amount | 124290.05 |
| Total Medical Medicare Standardized Payment Amount | 126473.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 291 |
| Number Of Beneficiaries Age 65 to 74 | 624 |
| Number Of Beneficiaries Age 75 to 84 | 541 |
| Number Of Beneficiaries Age Greater 84 | 269 |
| Number Of Female Beneficiaries | 860 |
| Number Of Male Beneficiaries | 865 |
| Number Of Non Hispanic White Beneficiaries | 1104 |
| Number Of Black or African American Beneficiaries | 386 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 182 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 318 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4542 |