| National Provider Identifier [NPI]: | 1699948588 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | REID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 BRECKENRIDGE ST |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | OWENSBORO |
| Zip Code Of The Provider | 423030839 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 4371 |
| Number Of Medicare Beneficiaries | 437 |
| Total Submitted Charge Amount | 597703.5 |
| Total Medicare Allowed Amount | 221902.6 |
| Total Medicare Payment Amount | 168614.94 |
| Total Medicare Standardized Payment Amount | 182055.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2353 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 30033 |
| Total Drug Medicare AllowedAmount | 13012.88 |
| Total Drug Medicare PaymentAmount | 9971.8 |
| Total Drug Medicare Standardized Payment Amount | 9971.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 2018 |
| Number Of Medicare Beneficiaries With Medical Services | 437 |
| Total Medical Submitted Charge Amount | 567670.5 |
| Total Medical Medicare Allowed Amount | 208889.72 |
| Total Medical Medicare Payment Amount | 158643.14 |
| Total Medical Medicare Standardized Payment Amount | 172083.45 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 289 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 402 |
| Number Of Black or African American Beneficiaries | |
| 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 | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3548 |