| National Provider Identifier [NPI]: | 1538162151 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8679 CONNECTICUT ST |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | MERRILLVILLE |
| Zip Code Of The Provider | 464106383 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 28044 |
| Number Of Medicare Beneficiaries | 1885 |
| Total Submitted Charge Amount | 4604567.17 |
| Total Medicare Allowed Amount | 4506438.61 |
| Total Medicare Payment Amount | 3441124.75 |
| Total Medicare Standardized Payment Amount | 3468569.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7592 |
| Number Of Medicare Beneficiaries With Drug Services | 441 |
| Total Drug Submitted ChargeAmount | 2630498.64 |
| Total Drug Medicare AllowedAmount | 2617599.04 |
| Total Drug Medicare PaymentAmount | 2036323.36 |
| Total Drug Medicare Standardized Payment Amount | 2036323.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 20452 |
| Number Of Medicare Beneficiaries With Medical Services | 1885 |
| Total Medical Submitted Charge Amount | 1974068.53 |
| Total Medical Medicare Allowed Amount | 1888839.57 |
| Total Medical Medicare Payment Amount | 1404801.39 |
| Total Medical Medicare Standardized Payment Amount | 1432246.12 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 630 |
| Number Of Beneficiaries Age Greater 84 | 487 |
| Number Of Female Beneficiaries | 1066 |
| Number Of Male Beneficiaries | 819 |
| Number Of Non Hispanic White Beneficiaries | 1544 |
| Number Of Black or African American Beneficiaries | 201 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 120 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1707 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6331 |