| National Provider Identifier [NPI]: | 1043286123 |
| Last Name Of The Provider | WILSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3601 5TH AVE |
| Street Address 2 Of The Provider | 4TH FLOOR FALK, COMPREHENSIVE LUNG CENTER |
| City Of The Provider | PITTSBURGH |
| Zip Code Of The Provider | 152133403 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1350 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 244366 |
| Total Medicare Allowed Amount | 96344.94 |
| Total Medicare Payment Amount | 73197.42 |
| Total Medicare Standardized Payment Amount | 75975.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 490 |
| Total Drug Medicare AllowedAmount | 421.43 |
| Total Drug Medicare PaymentAmount | 412.99 |
| Total Drug Medicare Standardized Payment Amount | 412.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1336 |
| Number Of Medicare Beneficiaries With Medical Services | 383 |
| Total Medical Submitted Charge Amount | 243876 |
| Total Medical Medicare Allowed Amount | 95923.51 |
| Total Medical Medicare Payment Amount | 72784.43 |
| Total Medical Medicare Standardized Payment Amount | 75562.47 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 313 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 55 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.6176 |