| National Provider Identifier [NPI]: | 1588836472 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1404 TUSCULUM BLVD |
| Street Address 2 Of The Provider | SUITE 2100/2300 |
| City Of The Provider | GREENEVILLE |
| Zip Code Of The Provider | 377454395 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 1215 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 56509 |
| Total Medicare Allowed Amount | 26089.07 |
| Total Medicare Payment Amount | 20435.18 |
| Total Medicare Standardized Payment Amount | 24575.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 319 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 650 |
| Total Drug Medicare AllowedAmount | 273.28 |
| Total Drug Medicare PaymentAmount | 245.63 |
| Total Drug Medicare Standardized Payment Amount | 245.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 896 |
| Number Of Medicare Beneficiaries With Medical Services | 113 |
| Total Medical Submitted Charge Amount | 55859 |
| Total Medical Medicare Allowed Amount | 25815.79 |
| Total Medical Medicare Payment Amount | 20189.55 |
| Total Medical Medicare Standardized Payment Amount | 24329.56 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 43 |
| 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 | 89 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0453 |