| National Provider Identifier [NPI]: | 1861466815 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | LESLIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1140 CYPRESS STATION DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770903057 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 44996 |
| Number Of Medicare Beneficiaries | 343 |
| Total Submitted Charge Amount | 2503969 |
| Total Medicare Allowed Amount | 1265646.24 |
| Total Medicare Payment Amount | 980219.81 |
| Total Medicare Standardized Payment Amount | 980473.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 41542 |
| Number Of Medicare Beneficiaries With Drug Services | 216 |
| Total Drug Submitted ChargeAmount | 2166248 |
| Total Drug Medicare AllowedAmount | 1126420.92 |
| Total Drug Medicare PaymentAmount | 874682.48 |
| Total Drug Medicare Standardized Payment Amount | 874682.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 3454 |
| Number Of Medicare Beneficiaries With Medical Services | 343 |
| Total Medical Submitted Charge Amount | 337721 |
| Total Medical Medicare Allowed Amount | 139225.32 |
| Total Medical Medicare Payment Amount | 105537.33 |
| Total Medical Medicare Standardized Payment Amount | 105790.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 281 |
| Number Of Black or African American Beneficiaries | 37 |
| 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 | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 42 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3681 |