| National Provider Identifier [NPI]: | 1851380448 |
| Last Name Of The Provider | HALEY |
| 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 | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 14822 |
| Number Of Medicare Beneficiaries | 764 |
| Total Submitted Charge Amount | 187016.56 |
| Total Medicare Allowed Amount | 159054.08 |
| Total Medicare Payment Amount | 118965.52 |
| Total Medicare Standardized Payment Amount | 127168.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13530 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 33413.9 |
| Total Drug Medicare AllowedAmount | 31754.69 |
| Total Drug Medicare PaymentAmount | 24423.76 |
| Total Drug Medicare Standardized Payment Amount | 24423.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1292 |
| Number Of Medicare Beneficiaries With Medical Services | 764 |
| Total Medical Submitted Charge Amount | 153602.66 |
| Total Medical Medicare Allowed Amount | 127299.39 |
| Total Medical Medicare Payment Amount | 94541.76 |
| Total Medical Medicare Standardized Payment Amount | 102744.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 219 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 436 |
| Number Of Non Hispanic White Beneficiaries | 618 |
| Number Of Black or African American Beneficiaries | 95 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 691 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.1606 |