| National Provider Identifier [NPI]: | 1225146830 |
| Last Name Of The Provider | DEAS |
| First Name Of The Provider | WILLIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2123 WRIGHTSBORO RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 309044777 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 2248 |
| Number Of Medicare Beneficiaries | 292 |
| Total Submitted Charge Amount | 401486.4 |
| Total Medicare Allowed Amount | 229060.34 |
| Total Medicare Payment Amount | 174045.76 |
| Total Medicare Standardized Payment Amount | 181500.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 308 |
| Total Drug Medicare AllowedAmount | 102.96 |
| Total Drug Medicare PaymentAmount | 100.92 |
| Total Drug Medicare Standardized Payment Amount | 100.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2236 |
| Number Of Medicare Beneficiaries With Medical Services | 292 |
| Total Medical Submitted Charge Amount | 401178.4 |
| Total Medical Medicare Allowed Amount | 228957.38 |
| Total Medical Medicare Payment Amount | 173944.84 |
| Total Medical Medicare Standardized Payment Amount | 181399.89 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 169 |
| 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 | 173 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.9437 |