| National Provider Identifier [NPI]: | 1013918127 |
| Last Name Of The Provider | WILLIAMSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 N EAST AVE |
| Street Address 2 Of The Provider | IMAGING DEPARTMENT |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 492011753 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 5976 |
| Number Of Medicare Beneficiaries | 3379 |
| Total Submitted Charge Amount | 814996 |
| Total Medicare Allowed Amount | 193900.16 |
| Total Medicare Payment Amount | 149472.67 |
| Total Medicare Standardized Payment Amount | 153963.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 5976 |
| Number Of Medicare Beneficiaries With Medical Services | 3379 |
| Total Medical Submitted Charge Amount | 814996 |
| Total Medical Medicare Allowed Amount | 193900.16 |
| Total Medical Medicare Payment Amount | 149472.67 |
| Total Medical Medicare Standardized Payment Amount | 153963.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 758 |
| Number Of Beneficiaries Age 65 to 74 | 1210 |
| Number Of Beneficiaries Age 75 to 84 | 933 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 2165 |
| Number Of Male Beneficiaries | 1214 |
| Number Of Non Hispanic White Beneficiaries | 3072 |
| Number Of Black or African American Beneficiaries | 229 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 917 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6986 |