| National Provider Identifier [NPI]: | 1356340103 |
| Last Name Of The Provider | WILBANKS |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7362 MIDLAND RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREELAND |
| Zip Code Of The Provider | 486238803 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 232 |
| Number Of Medicare Beneficiaries | 69 |
| Total Submitted Charge Amount | 20346 |
| Total Medicare Allowed Amount | 12410.06 |
| Total Medicare Payment Amount | 8963.63 |
| Total Medicare Standardized Payment Amount | 11357.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 212 |
| Total Drug Medicare AllowedAmount | 93.17 |
| Total Drug Medicare PaymentAmount | 53.97 |
| Total Drug Medicare Standardized Payment Amount | 53.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 216 |
| Number Of Medicare Beneficiaries With Medical Services | 69 |
| Total Medical Submitted Charge Amount | 20134 |
| Total Medical Medicare Allowed Amount | 12316.89 |
| Total Medical Medicare Payment Amount | 8909.66 |
| Total Medical Medicare Standardized Payment Amount | 11303.04 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 25 |
| 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 | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2396 |