| National Provider Identifier [NPI]: | 1457343063 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 12TH AVE N |
| Street Address 2 Of The Provider | SUITE 140W |
| City Of The Provider | BILLINGS |
| Zip Code Of The Provider | 591017506 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 3821 |
| Number Of Medicare Beneficiaries | 572 |
| Total Submitted Charge Amount | 1199800 |
| Total Medicare Allowed Amount | 312382.57 |
| Total Medicare Payment Amount | 249203.68 |
| Total Medicare Standardized Payment Amount | 250735.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1834 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 28425 |
| Total Drug Medicare AllowedAmount | 5306.92 |
| Total Drug Medicare PaymentAmount | 4004.62 |
| Total Drug Medicare Standardized Payment Amount | 4004.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 1987 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 1171375 |
| Total Medical Medicare Allowed Amount | 307075.65 |
| Total Medical Medicare Payment Amount | 245199.06 |
| Total Medical Medicare Standardized Payment Amount | 246731.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 240 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 360 |
| Number Of Male Beneficiaries | 212 |
| Number Of Non Hispanic White Beneficiaries | 536 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0784 |