| National Provider Identifier [NPI]: | 1902850902 |
| Last Name Of The Provider | WILMOTH |
| First Name Of The Provider | LAURIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1040 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 245411816 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 5853 |
| Number Of Medicare Beneficiaries | 945 |
| Total Submitted Charge Amount | 430321 |
| Total Medicare Allowed Amount | 185443.5 |
| Total Medicare Payment Amount | 142074.12 |
| Total Medicare Standardized Payment Amount | 164496.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1614 |
| Total Drug Medicare AllowedAmount | 657 |
| Total Drug Medicare PaymentAmount | 550.99 |
| Total Drug Medicare Standardized Payment Amount | 550.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 5799 |
| Number Of Medicare Beneficiaries With Medical Services | 945 |
| Total Medical Submitted Charge Amount | 428707 |
| Total Medical Medicare Allowed Amount | 184786.5 |
| Total Medical Medicare Payment Amount | 141523.13 |
| Total Medical Medicare Standardized Payment Amount | 163945.2 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 360 |
| Number Of Beneficiaries Age 75 to 84 | 340 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 713 |
| Number Of Non Hispanic White Beneficiaries | 693 |
| Number Of Black or African American Beneficiaries | 240 |
| 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 | 762 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3876 |