| National Provider Identifier [NPI]: | 1215904495 |
| Last Name Of The Provider | WIGLEY |
| First Name Of The Provider | KENNON |
| 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 | 2700 E 29TH STREET |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | BRYAN |
| Zip Code Of The Provider | 77802 |
| 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 | 64 |
| Number Of Services | 8919 |
| Number Of Medicare Beneficiaries | 1937 |
| Total Submitted Charge Amount | 2233494 |
| Total Medicare Allowed Amount | 630311.82 |
| Total Medicare Payment Amount | 472445.95 |
| Total Medicare Standardized Payment Amount | 499958.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1403 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 56117 |
| Total Drug Medicare AllowedAmount | 19675.58 |
| Total Drug Medicare PaymentAmount | 15304.34 |
| Total Drug Medicare Standardized Payment Amount | 15304.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 7516 |
| Number Of Medicare Beneficiaries With Medical Services | 1937 |
| Total Medical Submitted Charge Amount | 2177377 |
| Total Medical Medicare Allowed Amount | 610636.24 |
| Total Medical Medicare Payment Amount | 457141.61 |
| Total Medical Medicare Standardized Payment Amount | 484653.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 192 |
| Number Of Beneficiaries Age 65 to 74 | 686 |
| Number Of Beneficiaries Age 75 to 84 | 692 |
| Number Of Beneficiaries Age Greater 84 | 367 |
| Number Of Female Beneficiaries | 979 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 1556 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 372 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5214 |