| National Provider Identifier [NPI]: | 1881946259 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | SERENA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10 E 13TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GROVE |
| Zip Code Of The Provider | 743445300 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1617 |
| Number Of Medicare Beneficiaries | 369 |
| Total Submitted Charge Amount | 98433 |
| Total Medicare Allowed Amount | 36852.76 |
| Total Medicare Payment Amount | 26291.13 |
| Total Medicare Standardized Payment Amount | 33776.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 883 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 16018 |
| Total Drug Medicare AllowedAmount | 1855.53 |
| Total Drug Medicare PaymentAmount | 1356.06 |
| Total Drug Medicare Standardized Payment Amount | 1356.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 734 |
| Number Of Medicare Beneficiaries With Medical Services | 369 |
| Total Medical Submitted Charge Amount | 82415 |
| Total Medical Medicare Allowed Amount | 34997.23 |
| Total Medical Medicare Payment Amount | 24935.07 |
| Total Medical Medicare Standardized Payment Amount | 32420.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 221 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| 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 | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9619 |