| National Provider Identifier [NPI]: | 1932425923 |
| Last Name Of The Provider | CHISHOLM |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 S POTOMAC ST |
| Street Address 2 Of The Provider | #150 |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 800124528 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1877 |
| Number Of Medicare Beneficiaries | 698 |
| Total Submitted Charge Amount | 346258 |
| Total Medicare Allowed Amount | 186813.27 |
| Total Medicare Payment Amount | 144047.5 |
| Total Medicare Standardized Payment Amount | 143671.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 2773 |
| Total Drug Medicare AllowedAmount | 1252.28 |
| Total Drug Medicare PaymentAmount | 1225.76 |
| Total Drug Medicare Standardized Payment Amount | 1225.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1834 |
| Number Of Medicare Beneficiaries With Medical Services | 698 |
| Total Medical Submitted Charge Amount | 343485 |
| Total Medical Medicare Allowed Amount | 185560.99 |
| Total Medical Medicare Payment Amount | 142821.74 |
| Total Medical Medicare Standardized Payment Amount | 142445.95 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 568 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8436 |