| National Provider Identifier [NPI]: | 1932166394 |
| Last Name Of The Provider | WILBER |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1165 MONTGOMERY DR |
| Street Address 2 Of The Provider | PATHOLOGY DEPT |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954054801 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 10233 |
| Number Of Medicare Beneficiaries | 3403 |
| Total Submitted Charge Amount | 550207.15 |
| Total Medicare Allowed Amount | 330897.42 |
| Total Medicare Payment Amount | 248301.31 |
| Total Medicare Standardized Payment Amount | 189829.35 |
| 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 | 33 |
| Number Of Medical Services | 10233 |
| Number Of Medicare Beneficiaries With Medical Services | 3403 |
| Total Medical Submitted Charge Amount | 550207.15 |
| Total Medical Medicare Allowed Amount | 330897.42 |
| Total Medical Medicare Payment Amount | 248301.31 |
| Total Medical Medicare Standardized Payment Amount | 189829.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 449 |
| Number Of Beneficiaries Age 65 to 74 | 1566 |
| Number Of Beneficiaries Age 75 to 84 | 934 |
| Number Of Beneficiaries Age Greater 84 | 454 |
| Number Of Female Beneficiaries | 1891 |
| Number Of Male Beneficiaries | 1512 |
| Number Of Non Hispanic White Beneficiaries | 2993 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | 223 |
| Number Of American Indian Alaska Native Beneficiaries | 42 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2671 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 732 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2724 |