National Provider Identifier [NPI]: |
1154514842 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
CLARENCE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 S IH 35 |
Street Address 2 Of The Provider |
SUITE N-5 |
City Of The Provider |
ROUND ROCK |
Zip Code Of The Provider |
786816900 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
314 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
31834.53 |
Total Medicare Allowed Amount |
14057.28 |
Total Medicare Payment Amount |
9087.13 |
Total Medicare Standardized Payment Amount |
9956.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
721.53 |
Total Drug Medicare AllowedAmount |
76.53 |
Total Drug Medicare PaymentAmount |
57.76 |
Total Drug Medicare Standardized Payment Amount |
57.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
214 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
31113 |
Total Medical Medicare Allowed Amount |
13980.75 |
Total Medical Medicare Payment Amount |
9029.37 |
Total Medical Medicare Standardized Payment Amount |
9898.46 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
124 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9515 |