| National Provider Identifier [NPI]: | 1013174200 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | LINDSEY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3999 RICHMOND RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEACHWOOD |
| Zip Code Of The Provider | 441226046 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 2515 |
| Number Of Medicare Beneficiaries | 1724 |
| Total Submitted Charge Amount | 196517 |
| Total Medicare Allowed Amount | 62463.13 |
| Total Medicare Payment Amount | 48572.28 |
| Total Medicare Standardized Payment Amount | 50592.36 |
| 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 | 114 |
| Number Of Medical Services | 2515 |
| Number Of Medicare Beneficiaries With Medical Services | 1724 |
| Total Medical Submitted Charge Amount | 196517 |
| Total Medical Medicare Allowed Amount | 62463.13 |
| Total Medical Medicare Payment Amount | 48572.28 |
| Total Medical Medicare Standardized Payment Amount | 50592.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 298 |
| Number Of Beneficiaries Age 65 to 74 | 619 |
| Number Of Beneficiaries Age 75 to 84 | 489 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 1035 |
| Number Of Male Beneficiaries | 689 |
| Number Of Non Hispanic White Beneficiaries | 1413 |
| Number Of Black or African American Beneficiaries | 244 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1288 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 436 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7584 |