| National Provider Identifier [NPI]: | 1972711422 |
| Last Name Of The Provider | WILLIAMSON |
| First Name Of The Provider | CLINTON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3330 NW 56TH |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731124426 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 24019 |
| Number Of Medicare Beneficiaries | 4687 |
| Total Submitted Charge Amount | 351177.47 |
| Total Medicare Allowed Amount | 325052.17 |
| Total Medicare Payment Amount | 243872.42 |
| Total Medicare Standardized Payment Amount | 267802.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 16835 |
| Number Of Medicare Beneficiaries With Drug Services | 183 |
| Total Drug Submitted ChargeAmount | 2965.3 |
| Total Drug Medicare AllowedAmount | 2296.71 |
| Total Drug Medicare PaymentAmount | 1748.25 |
| Total Drug Medicare Standardized Payment Amount | 1748.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 7184 |
| Number Of Medicare Beneficiaries With Medical Services | 4687 |
| Total Medical Submitted Charge Amount | 348212.17 |
| Total Medical Medicare Allowed Amount | 322755.46 |
| Total Medical Medicare Payment Amount | 242124.17 |
| Total Medical Medicare Standardized Payment Amount | 266054.2 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 873 |
| Number Of Beneficiaries Age 65 to 74 | 1832 |
| Number Of Beneficiaries Age 75 to 84 | 1401 |
| Number Of Beneficiaries Age Greater 84 | 581 |
| Number Of Female Beneficiaries | 2613 |
| Number Of Male Beneficiaries | 2074 |
| Number Of Non Hispanic White Beneficiaries | 3952 |
| Number Of Black or African American Beneficiaries | 342 |
| Number Of AsianPacific Islander Beneficiaries | 59 |
| Number Of Hispanic Beneficiaries | 97 |
| Number Of American Indian Alaska Native Beneficiaries | 205 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3755 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 932 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.983 |