| National Provider Identifier [NPI]: | 1568401057 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JARED |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1190 BAKER ST |
| Street Address 2 Of The Provider | 100 |
| City Of The Provider | COSTA MESA |
| Zip Code Of The Provider | 926264108 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 449 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 54024 |
| Total Medicare Allowed Amount | 38543.11 |
| Total Medicare Payment Amount | 28209.57 |
| Total Medicare Standardized Payment Amount | 25213.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1692 |
| Total Drug Medicare AllowedAmount | 1182.6 |
| Total Drug Medicare PaymentAmount | 1152.33 |
| Total Drug Medicare Standardized Payment Amount | 1152.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 403 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 52332 |
| Total Medical Medicare Allowed Amount | 37360.51 |
| Total Medical Medicare Payment Amount | 27057.24 |
| Total Medical Medicare Standardized Payment Amount | 24061.29 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9299 |