| National Provider Identifier [NPI]: | 1023091931 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 476 WILLIAMS WAY |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | MOAB |
| Zip Code Of The Provider | 845322065 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 2382 |
| Number Of Medicare Beneficiaries | 536 |
| Total Submitted Charge Amount | 293195.5 |
| Total Medicare Allowed Amount | 147050.66 |
| Total Medicare Payment Amount | 109578.89 |
| Total Medicare Standardized Payment Amount | 113636.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 426 |
| Number Of Medicare Beneficiaries With Drug Services | 337 |
| Total Drug Submitted ChargeAmount | 17511.5 |
| Total Drug Medicare AllowedAmount | 5511.44 |
| Total Drug Medicare PaymentAmount | 5356.84 |
| Total Drug Medicare Standardized Payment Amount | 5356.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1956 |
| Number Of Medicare Beneficiaries With Medical Services | 536 |
| Total Medical Submitted Charge Amount | 275684 |
| Total Medical Medicare Allowed Amount | 141539.22 |
| Total Medical Medicare Payment Amount | 104222.05 |
| Total Medical Medicare Standardized Payment Amount | 108279.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 518 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8449 |