| National Provider Identifier [NPI]: | 1316011083 |
| Last Name Of The Provider | WIELER |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 MONTEREY ST |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | SAN LUIS OBISPO |
| Zip Code Of The Provider | 934013102 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 21729 |
| Number Of Medicare Beneficiaries | 2911 |
| Total Submitted Charge Amount | 1439087 |
| Total Medicare Allowed Amount | 651608.8 |
| Total Medicare Payment Amount | 542037.28 |
| Total Medicare Standardized Payment Amount | 509981.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 15156 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 36989 |
| Total Drug Medicare AllowedAmount | 3661.92 |
| Total Drug Medicare PaymentAmount | 2870.63 |
| Total Drug Medicare Standardized Payment Amount | 2870.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 6573 |
| Number Of Medicare Beneficiaries With Medical Services | 2911 |
| Total Medical Submitted Charge Amount | 1402098 |
| Total Medical Medicare Allowed Amount | 647946.88 |
| Total Medical Medicare Payment Amount | 539166.65 |
| Total Medical Medicare Standardized Payment Amount | 507110.68 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 1764 |
| Number Of Beneficiaries Age 75 to 84 | 766 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 2428 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 2686 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2712 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 199 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7842 |