| National Provider Identifier [NPI]: | 1164434973 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | BLANFORD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2180 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAILUKU |
| Zip Code Of The Provider | 967931666 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 5804 |
| Number Of Medicare Beneficiaries | 1191 |
| Total Submitted Charge Amount | 247497.46 |
| Total Medicare Allowed Amount | 189092.17 |
| Total Medicare Payment Amount | 146901.97 |
| Total Medicare Standardized Payment Amount | 135935.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3806 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 2639.94 |
| Total Drug Medicare AllowedAmount | 766.23 |
| Total Drug Medicare PaymentAmount | 589.21 |
| Total Drug Medicare Standardized Payment Amount | 589.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 1998 |
| Number Of Medicare Beneficiaries With Medical Services | 1191 |
| Total Medical Submitted Charge Amount | 244857.52 |
| Total Medical Medicare Allowed Amount | 188325.94 |
| Total Medical Medicare Payment Amount | 146312.76 |
| Total Medical Medicare Standardized Payment Amount | 135345.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 586 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 802 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 487 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 507 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 106 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1073 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9942 |