| National Provider Identifier [NPI]: | 1700180197 |
| Last Name Of The Provider | VILLARD |
| First Name Of The Provider | WANDA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 BEN MERRITT DR |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 762343848 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 988 |
| Number Of Medicare Beneficiaries | 225 |
| Total Submitted Charge Amount | 155527 |
| Total Medicare Allowed Amount | 39085.24 |
| Total Medicare Payment Amount | 30510.09 |
| Total Medicare Standardized Payment Amount | 36891.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 988 |
| Number Of Medicare Beneficiaries With Medical Services | 225 |
| Total Medical Submitted Charge Amount | 155527 |
| Total Medical Medicare Allowed Amount | 39085.24 |
| Total Medical Medicare Payment Amount | 30510.09 |
| Total Medical Medicare Standardized Payment Amount | 36891.46 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 102 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 28 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 48 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.3803 |