| National Provider Identifier [NPI]: | 1235262056 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13550 JOG RD STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DELRAY BEACH |
| Zip Code Of The Provider | 334463808 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Therapist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 23839 |
| Number Of Medicare Beneficiaries | 1262 |
| Total Submitted Charge Amount | 1277812 |
| Total Medicare Allowed Amount | 687273.75 |
| Total Medicare Payment Amount | 528899.84 |
| Total Medicare Standardized Payment Amount | 367965.12 |
| 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 | 16 |
| Number Of Medical Services | 23839 |
| Number Of Medicare Beneficiaries With Medical Services | 1262 |
| Total Medical Submitted Charge Amount | 1277812 |
| Total Medical Medicare Allowed Amount | 687273.75 |
| Total Medical Medicare Payment Amount | 528899.84 |
| Total Medical Medicare Standardized Payment Amount | 367965.12 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 525 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 777 |
| Number Of Male Beneficiaries | 485 |
| Number Of Non Hispanic White Beneficiaries | 1219 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5093 |