| National Provider Identifier [NPI]: | 1306906250 |
| Last Name Of The Provider | WILKERSON |
| First Name Of The Provider | EVELYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | TIPTON MEDICAL CLINIC |
| Street Address 2 Of The Provider | 575 N THOMPSON RD |
| City Of The Provider | TIPTON |
| Zip Code Of The Provider | 932729756 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 75 |
| Number Of Medicare Beneficiaries | 47 |
| Total Submitted Charge Amount | 4988.58 |
| Total Medicare Allowed Amount | 3463.3 |
| Total Medicare Payment Amount | 2779.82 |
| Total Medicare Standardized Payment Amount | 2852.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1394.88 |
| Total Drug Medicare AllowedAmount | 436.55 |
| Total Drug Medicare PaymentAmount | 424.95 |
| Total Drug Medicare Standardized Payment Amount | 424.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 61 |
| Number Of Medicare Beneficiaries With Medical Services | 47 |
| Total Medical Submitted Charge Amount | 3593.7 |
| Total Medical Medicare Allowed Amount | 3026.75 |
| Total Medical Medicare Payment Amount | 2354.87 |
| Total Medical Medicare Standardized Payment Amount | 2427.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 32 |
| Number Of Male Beneficiaries | 15 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7887 |