| National Provider Identifier [NPI]: | 1841269248 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | WALTER |
| 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 | 1433 5TH ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 994032714 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6682 |
| Number Of Medicare Beneficiaries | 1519 |
| Total Submitted Charge Amount | 831350 |
| Total Medicare Allowed Amount | 440609.91 |
| Total Medicare Payment Amount | 311841.68 |
| Total Medicare Standardized Payment Amount | 307835.78 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 602 |
| Number Of Beneficiaries Age 75 to 84 | 574 |
| Number Of Beneficiaries Age Greater 84 | 269 |
| Number Of Female Beneficiaries | 676 |
| Number Of Male Beneficiaries | 843 |
| Number Of Non Hispanic White Beneficiaries | 1482 |
| Number Of Black or African American Beneficiaries | |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1416 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0322 |