National Provider Identifier [NPI]: |
1982635173 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2230 SW 19TH AVENUE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344711391 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
178 |
Number Of Services |
9845 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
571044.1 |
Total Medicare Allowed Amount |
292308.44 |
Total Medicare Payment Amount |
230621.63 |
Total Medicare Standardized Payment Amount |
236048.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
1586.5 |
Number Of Medicare Beneficiaries With Drug Services |
142 |
Total Drug Submitted ChargeAmount |
6076.21 |
Total Drug Medicare AllowedAmount |
3467.99 |
Total Drug Medicare PaymentAmount |
3225.43 |
Total Drug Medicare Standardized Payment Amount |
3225.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
164 |
Number Of Medical Services |
8258.5 |
Number Of Medicare Beneficiaries With Medical Services |
526 |
Total Medical Submitted Charge Amount |
564967.89 |
Total Medical Medicare Allowed Amount |
288840.45 |
Total Medical Medicare Payment Amount |
227396.2 |
Total Medical Medicare Standardized Payment Amount |
232822.98 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
263 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
448 |
Number Of Black or African American Beneficiaries |
56 |
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 |
445 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1515 |