National Provider Identifier [NPI]: |
1548269483 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ALEX |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 GRESHAM DR |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235071901 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1380 |
Number Of Medicare Beneficiaries |
730 |
Total Submitted Charge Amount |
557702.5 |
Total Medicare Allowed Amount |
168892.25 |
Total Medicare Payment Amount |
132168.84 |
Total Medicare Standardized Payment Amount |
135258.69 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
211 |
Number Of Beneficiaries Age 65 to 74 |
290 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
317 |
Number Of Non Hispanic White Beneficiaries |
246 |
Number Of Black or African American Beneficiaries |
457 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0033 |