| National Provider Identifier [NPI]: | 1386604072 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 IRMC DR |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | INDIANA |
| Zip Code Of The Provider | 157013674 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 1037 |
| Number Of Medicare Beneficiaries | 174 |
| Total Submitted Charge Amount | 239441 |
| Total Medicare Allowed Amount | 102381.33 |
| Total Medicare Payment Amount | 77300.43 |
| Total Medicare Standardized Payment Amount | 77748.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 305 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 20891 |
| Total Drug Medicare AllowedAmount | 15919.72 |
| Total Drug Medicare PaymentAmount | 12221.33 |
| Total Drug Medicare Standardized Payment Amount | 12221.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 732 |
| Number Of Medicare Beneficiaries With Medical Services | 174 |
| Total Medical Submitted Charge Amount | 218550 |
| Total Medical Medicare Allowed Amount | 86461.61 |
| Total Medical Medicare Payment Amount | 65079.1 |
| Total Medical Medicare Standardized Payment Amount | 65527.31 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1637 |