| National Provider Identifier [NPI]: | 1447373832 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JOSHUA |
| 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 | 6000 UNIVERSITY AVE STE 450 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668229 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 9574 |
| Number Of Medicare Beneficiaries | 1104 |
| Total Submitted Charge Amount | 1525279 |
| Total Medicare Allowed Amount | 659797.76 |
| Total Medicare Payment Amount | 494389.34 |
| Total Medicare Standardized Payment Amount | 486673.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 8879 |
| Total Drug Medicare AllowedAmount | 8463.88 |
| Total Drug Medicare PaymentAmount | 6564.01 |
| Total Drug Medicare Standardized Payment Amount | 6564.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 9438 |
| Number Of Medicare Beneficiaries With Medical Services | 1104 |
| Total Medical Submitted Charge Amount | 1516400 |
| Total Medical Medicare Allowed Amount | 651333.88 |
| Total Medical Medicare Payment Amount | 487825.33 |
| Total Medical Medicare Standardized Payment Amount | 480109.85 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 487 |
| Number Of Beneficiaries Age 75 to 84 | 401 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 565 |
| Number Of Male Beneficiaries | 539 |
| Number Of Non Hispanic White Beneficiaries | 1080 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1052 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.921 |