| National Provider Identifier [NPI]: | 1053346452 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | LUKE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 CARONDELET DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641144673 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 229 |
| Number Of Services | 5290 |
| Number Of Medicare Beneficiaries | 3085 |
| Total Submitted Charge Amount | 707708.59 |
| Total Medicare Allowed Amount | 180688.28 |
| Total Medicare Payment Amount | 136774.01 |
| Total Medicare Standardized Payment Amount | 142772.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 326 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2267.4 |
| Total Drug Medicare AllowedAmount | 513.29 |
| Total Drug Medicare PaymentAmount | 402.61 |
| Total Drug Medicare Standardized Payment Amount | 402.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 224 |
| Number Of Medical Services | 4964 |
| Number Of Medicare Beneficiaries With Medical Services | 3085 |
| Total Medical Submitted Charge Amount | 705441.19 |
| Total Medical Medicare Allowed Amount | 180174.99 |
| Total Medical Medicare Payment Amount | 136371.4 |
| Total Medical Medicare Standardized Payment Amount | 142370.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 575 |
| Number Of Beneficiaries Age 65 to 74 | 978 |
| Number Of Beneficiaries Age 75 to 84 | 912 |
| Number Of Beneficiaries Age Greater 84 | 620 |
| Number Of Female Beneficiaries | 1882 |
| Number Of Male Beneficiaries | 1203 |
| Number Of Non Hispanic White Beneficiaries | 2721 |
| Number Of Black or African American Beneficiaries | 274 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 721 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6162 |