| National Provider Identifier [NPI]: | 1215929856 |
| Last Name Of The Provider | WILCOX |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 CLINTON ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPT |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494425502 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 5614 |
| Number Of Medicare Beneficiaries | 3457 |
| Total Submitted Charge Amount | 558345.4 |
| Total Medicare Allowed Amount | 153226.24 |
| Total Medicare Payment Amount | 121842.41 |
| Total Medicare Standardized Payment Amount | 125714.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 216 |
| Number Of Medical Services | 5614 |
| Number Of Medicare Beneficiaries With Medical Services | 3457 |
| Total Medical Submitted Charge Amount | 558345.4 |
| Total Medical Medicare Allowed Amount | 153226.24 |
| Total Medical Medicare Payment Amount | 121842.41 |
| Total Medical Medicare Standardized Payment Amount | 125714.01 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 878 |
| Number Of Beneficiaries Age 65 to 74 | 1039 |
| Number Of Beneficiaries Age 75 to 84 | 928 |
| Number Of Beneficiaries Age Greater 84 | 612 |
| Number Of Female Beneficiaries | 2137 |
| Number Of Male Beneficiaries | 1320 |
| Number Of Non Hispanic White Beneficiaries | 2890 |
| Number Of Black or African American Beneficiaries | 445 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1174 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7929 |