| National Provider Identifier [NPI]: | 1720213382 |
| Last Name Of The Provider | WILLIMANN |
| First Name Of The Provider | CASEY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2609 GLENN HENDREN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERTY |
| Zip Code Of The Provider | 640683313 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1487 |
| Number Of Medicare Beneficiaries | 468 |
| Total Submitted Charge Amount | 152107 |
| Total Medicare Allowed Amount | 104185.26 |
| Total Medicare Payment Amount | 79565.2 |
| Total Medicare Standardized Payment Amount | 81213.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 1370 |
| Total Drug Medicare AllowedAmount | 1086.34 |
| Total Drug Medicare PaymentAmount | 1060.42 |
| Total Drug Medicare Standardized Payment Amount | 1060.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1433 |
| Number Of Medicare Beneficiaries With Medical Services | 468 |
| Total Medical Submitted Charge Amount | 150737 |
| Total Medical Medicare Allowed Amount | 103098.92 |
| Total Medical Medicare Payment Amount | 78504.78 |
| Total Medical Medicare Standardized Payment Amount | 80153.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 324 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 445 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 384 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3043 |