| National Provider Identifier [NPI]: | 1932140944 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | MONIQUE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3 COOPER PLZ |
| Street Address 2 Of The Provider | SUITE 411 |
| City Of The Provider | CAMDEN |
| Zip Code Of The Provider | 081031438 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 973 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 340018 |
| Total Medicare Allowed Amount | 81831.73 |
| Total Medicare Payment Amount | 61935.35 |
| Total Medicare Standardized Payment Amount | 65576.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 187 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 184496 |
| Total Drug Medicare AllowedAmount | 38152.16 |
| Total Drug Medicare PaymentAmount | 29662.86 |
| Total Drug Medicare Standardized Payment Amount | 29662.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 786 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 155522 |
| Total Medical Medicare Allowed Amount | 43679.57 |
| Total Medical Medicare Payment Amount | 32272.49 |
| Total Medical Medicare Standardized Payment Amount | 35913.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3105 |