| National Provider Identifier [NPI]: | 1104131515 |
| Last Name Of The Provider | WILCHER |
| First Name Of The Provider | TONI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APN-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8177 CLEARVISTA PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462561662 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 197 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 11354 |
| Total Medicare Allowed Amount | 5929.94 |
| Total Medicare Payment Amount | 4247.59 |
| Total Medicare Standardized Payment Amount | 5424.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 62 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 280 |
| Total Drug Medicare AllowedAmount | 109.74 |
| Total Drug Medicare PaymentAmount | 95.75 |
| Total Drug Medicare Standardized Payment Amount | 95.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 135 |
| Number Of Medicare Beneficiaries With Medical Services | 79 |
| Total Medical Submitted Charge Amount | 11074 |
| Total Medical Medicare Allowed Amount | 5820.2 |
| Total Medical Medicare Payment Amount | 4151.84 |
| Total Medical Medicare Standardized Payment Amount | 5328.29 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9955 |