| National Provider Identifier [NPI]: | 1386668762 |
| Last Name Of The Provider | WISEMAN |
| First Name Of The Provider | MERLE |
| 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 | 715 N COLLEGE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EL DORADO |
| Zip Code Of The Provider | 717304403 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1444 |
| Number Of Medicare Beneficiaries | 353 |
| Total Submitted Charge Amount | 71650.28 |
| Total Medicare Allowed Amount | 71245.94 |
| Total Medicare Payment Amount | 45989.48 |
| Total Medicare Standardized Payment Amount | 65255.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 471 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2826 |
| Total Drug Medicare AllowedAmount | 2822.68 |
| Total Drug Medicare PaymentAmount | 1857.92 |
| Total Drug Medicare Standardized Payment Amount | 1857.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 973 |
| Number Of Medicare Beneficiaries With Medical Services | 353 |
| Total Medical Submitted Charge Amount | 68824.28 |
| Total Medical Medicare Allowed Amount | 68423.26 |
| Total Medical Medicare Payment Amount | 44131.56 |
| Total Medical Medicare Standardized Payment Amount | 63397.7 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 297 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 195 |
| 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 | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 268 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 15 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 50 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0933 |