| National Provider Identifier [NPI]: | 1013056985 |
| Last Name Of The Provider | GAMBRELL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 CLINIC AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 301174401 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1492 |
| Number Of Medicare Beneficiaries | 376 |
| Total Submitted Charge Amount | 223209 |
| Total Medicare Allowed Amount | 85707.24 |
| Total Medicare Payment Amount | 61276.6 |
| Total Medicare Standardized Payment Amount | 66365.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 153 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 2870 |
| Total Drug Medicare AllowedAmount | 763.51 |
| Total Drug Medicare PaymentAmount | 539.22 |
| Total Drug Medicare Standardized Payment Amount | 539.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1339 |
| Number Of Medicare Beneficiaries With Medical Services | 376 |
| Total Medical Submitted Charge Amount | 220339 |
| Total Medical Medicare Allowed Amount | 84943.73 |
| Total Medical Medicare Payment Amount | 60737.38 |
| Total Medical Medicare Standardized Payment Amount | 65826.46 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 184 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 352 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2561 |