| National Provider Identifier [NPI]: | 1417910621 |
| Last Name Of The Provider | STAFFORD |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 430 MORTON PLANT ST |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563398 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 6182 |
| Number Of Medicare Beneficiaries | 1041 |
| Total Submitted Charge Amount | 906334 |
| Total Medicare Allowed Amount | 431875.79 |
| Total Medicare Payment Amount | 324525.13 |
| Total Medicare Standardized Payment Amount | 327508.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 493 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 76830 |
| Total Drug Medicare AllowedAmount | 43802.27 |
| Total Drug Medicare PaymentAmount | 34158.95 |
| Total Drug Medicare Standardized Payment Amount | 34158.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 5689 |
| Number Of Medicare Beneficiaries With Medical Services | 1041 |
| Total Medical Submitted Charge Amount | 829504 |
| Total Medical Medicare Allowed Amount | 388073.52 |
| Total Medical Medicare Payment Amount | 290366.18 |
| Total Medical Medicare Standardized Payment Amount | 293349.24 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 416 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 300 |
| Number Of Male Beneficiaries | 741 |
| Number Of Non Hispanic White Beneficiaries | 980 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 960 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4842 |