| National Provider Identifier [NPI]: | 1245239359 |
| Last Name Of The Provider | SURBER |
| 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 | 2850 LEWIS LN |
| Street Address 2 Of The Provider | STE. 101 |
| City Of The Provider | PARIS |
| Zip Code Of The Provider | 754609383 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 370 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 38690.53 |
| Total Medicare Allowed Amount | 38196.63 |
| Total Medicare Payment Amount | 29955.88 |
| Total Medicare Standardized Payment Amount | 30148.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 176.26 |
| Total Drug Medicare AllowedAmount | 168.56 |
| Total Drug Medicare PaymentAmount | 165.2 |
| Total Drug Medicare Standardized Payment Amount | 165.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 356 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 38514.27 |
| Total Medical Medicare Allowed Amount | 38028.07 |
| Total Medical Medicare Payment Amount | 29790.68 |
| Total Medical Medicare Standardized Payment Amount | 29983.07 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 91 |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.0261 |