| National Provider Identifier [NPI]: | 1669440228 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1521 S STAPLES ST |
| Street Address 2 Of The Provider | SUITES 301 & 304 |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784043150 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 239 |
| Number Of Services | 24895 |
| Number Of Medicare Beneficiaries | 3167 |
| Total Submitted Charge Amount | 768690.5 |
| Total Medicare Allowed Amount | 258811.87 |
| Total Medicare Payment Amount | 190080.17 |
| Total Medicare Standardized Payment Amount | 204020.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 19659 |
| Number Of Medicare Beneficiaries With Drug Services | 201 |
| Total Drug Submitted ChargeAmount | 11626.5 |
| Total Drug Medicare AllowedAmount | 4034.13 |
| Total Drug Medicare PaymentAmount | 3159.71 |
| Total Drug Medicare Standardized Payment Amount | 3159.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 232 |
| Number Of Medical Services | 5236 |
| Number Of Medicare Beneficiaries With Medical Services | 3167 |
| Total Medical Submitted Charge Amount | 757064 |
| Total Medical Medicare Allowed Amount | 254777.74 |
| Total Medical Medicare Payment Amount | 186920.46 |
| Total Medical Medicare Standardized Payment Amount | 200861.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 570 |
| Number Of Beneficiaries Age 65 to 74 | 1179 |
| Number Of Beneficiaries Age 75 to 84 | 937 |
| Number Of Beneficiaries Age Greater 84 | 481 |
| Number Of Female Beneficiaries | 1821 |
| Number Of Male Beneficiaries | 1346 |
| Number Of Non Hispanic White Beneficiaries | 1838 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 1219 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2340 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 827 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8497 |