| National Provider Identifier [NPI]: | 1164477287 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | WENDELL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 S 40TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUSKOGEE |
| Zip Code Of The Provider | 744014915 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 7697 |
| Number Of Medicare Beneficiaries | 1420 |
| Total Submitted Charge Amount | 1376347 |
| Total Medicare Allowed Amount | 454341.39 |
| Total Medicare Payment Amount | 347111.16 |
| Total Medicare Standardized Payment Amount | 372020.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 256 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 6630 |
| Total Drug Medicare AllowedAmount | 383.96 |
| Total Drug Medicare PaymentAmount | 324.03 |
| Total Drug Medicare Standardized Payment Amount | 324.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 7441 |
| Number Of Medicare Beneficiaries With Medical Services | 1420 |
| Total Medical Submitted Charge Amount | 1369717 |
| Total Medical Medicare Allowed Amount | 453957.43 |
| Total Medical Medicare Payment Amount | 346787.13 |
| Total Medical Medicare Standardized Payment Amount | 371696.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 454 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 882 |
| Number Of Male Beneficiaries | 538 |
| Number Of Non Hispanic White Beneficiaries | 1052 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 176 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 789 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 631 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9664 |