| National Provider Identifier [NPI]: | 1285616375 |
| Last Name Of The Provider | WILDE |
| First Name Of The Provider | CORIN |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 E CENTENNIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITTSBURG |
| Zip Code Of The Provider | 667626505 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 6816 |
| Number Of Medicare Beneficiaries | 1256 |
| Total Submitted Charge Amount | 479208.82 |
| Total Medicare Allowed Amount | 306199.86 |
| Total Medicare Payment Amount | 215208.53 |
| Total Medicare Standardized Payment Amount | 231973.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 148 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 5635.2 |
| Total Drug Medicare AllowedAmount | 4834.24 |
| Total Drug Medicare PaymentAmount | 3790.04 |
| Total Drug Medicare Standardized Payment Amount | 3790.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 6668 |
| Number Of Medicare Beneficiaries With Medical Services | 1256 |
| Total Medical Submitted Charge Amount | 473573.62 |
| Total Medical Medicare Allowed Amount | 301365.62 |
| Total Medical Medicare Payment Amount | 211418.49 |
| Total Medical Medicare Standardized Payment Amount | 228183.88 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 436 |
| Number Of Female Beneficiaries | 802 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 1235 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 925 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 331 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.507 |