| National Provider Identifier [NPI]: | 1649267667 |
| Last Name Of The Provider | FREEMAN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 136 S HOUSTON LAKE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARNER ROBINS |
| Zip Code Of The Provider | 310886300 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 21296 |
| Number Of Medicare Beneficiaries | 2964 |
| Total Submitted Charge Amount | 2029607.5 |
| Total Medicare Allowed Amount | 1459586.82 |
| Total Medicare Payment Amount | 1099662.18 |
| Total Medicare Standardized Payment Amount | 1158815.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 282 |
| Number Of Medicare Beneficiaries With Drug Services | 235 |
| Total Drug Submitted ChargeAmount | 50165 |
| Total Drug Medicare AllowedAmount | 49009.82 |
| Total Drug Medicare PaymentAmount | 38306.75 |
| Total Drug Medicare Standardized Payment Amount | 38306.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 21014 |
| Number Of Medicare Beneficiaries With Medical Services | 2964 |
| Total Medical Submitted Charge Amount | 1979442.5 |
| Total Medical Medicare Allowed Amount | 1410577 |
| Total Medical Medicare Payment Amount | 1061355.43 |
| Total Medical Medicare Standardized Payment Amount | 1120509.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 1183 |
| Number Of Beneficiaries Age 75 to 84 | 1286 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1529 |
| Number Of Male Beneficiaries | 1435 |
| Number Of Non Hispanic White Beneficiaries | 2829 |
| Number Of Black or African American Beneficiaries | 86 |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2845 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0928 |