| National Provider Identifier [NPI]: | 1801021548 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 W 8TH ST # C506 |
| Street Address 2 Of The Provider | CLINICAL CENTER, 1ST FLOOR |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322096511 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 613 |
| Number Of Medicare Beneficiaries | 528 |
| Total Submitted Charge Amount | 306892 |
| Total Medicare Allowed Amount | 86020.88 |
| Total Medicare Payment Amount | 66703.03 |
| Total Medicare Standardized Payment Amount | 65826.02 |
| 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 | 25 |
| Number Of Medical Services | 613 |
| Number Of Medicare Beneficiaries With Medical Services | 528 |
| Total Medical Submitted Charge Amount | 306892 |
| Total Medical Medicare Allowed Amount | 86020.88 |
| Total Medical Medicare Payment Amount | 66703.03 |
| Total Medical Medicare Standardized Payment Amount | 65826.02 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 254 |
| Number Of Black or African American Beneficiaries | 256 |
| 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 | 186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 342 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4283 |