| National Provider Identifier [NPI]: | 1316187057 |
| Last Name Of The Provider | WILKINSON |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 FOXFIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST CHARLES |
| Zip Code Of The Provider | 601745799 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 597 |
| Number Of Medicare Beneficiaries | 349 |
| Total Submitted Charge Amount | 82674.01 |
| Total Medicare Allowed Amount | 41534.39 |
| Total Medicare Payment Amount | 29225.67 |
| Total Medicare Standardized Payment Amount | 33082.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1252.01 |
| Total Drug Medicare AllowedAmount | 702.52 |
| Total Drug Medicare PaymentAmount | 671.19 |
| Total Drug Medicare Standardized Payment Amount | 671.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 569 |
| Number Of Medicare Beneficiaries With Medical Services | 349 |
| Total Medical Submitted Charge Amount | 81422 |
| Total Medical Medicare Allowed Amount | 40831.87 |
| Total Medical Medicare Payment Amount | 28554.48 |
| Total Medical Medicare Standardized Payment Amount | 32411.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 275 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 324 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0041 |