| National Provider Identifier [NPI]: | 1750390068 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 S 7TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OZARK |
| Zip Code Of The Provider | 729493131 |
| 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 | 97 |
| Number Of Services | 4561 |
| Number Of Medicare Beneficiaries | 545 |
| Total Submitted Charge Amount | 324252.8 |
| Total Medicare Allowed Amount | 191576.55 |
| Total Medicare Payment Amount | 132984.48 |
| Total Medicare Standardized Payment Amount | 146926.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 411 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 16477.8 |
| Total Drug Medicare AllowedAmount | 9487.65 |
| Total Drug Medicare PaymentAmount | 8977.95 |
| Total Drug Medicare Standardized Payment Amount | 8977.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 4150 |
| Number Of Medicare Beneficiaries With Medical Services | 545 |
| Total Medical Submitted Charge Amount | 307775 |
| Total Medical Medicare Allowed Amount | 182088.9 |
| Total Medical Medicare Payment Amount | 124006.53 |
| Total Medical Medicare Standardized Payment Amount | 137948.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 175 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0778 |