| National Provider Identifier [NPI]: | 1356340475 |
| Last Name Of The Provider | PROCTOR |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 316 CALHOUN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLESTON |
| Zip Code Of The Provider | 294011113 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 6472 |
| Number Of Medicare Beneficiaries | 4663 |
| Total Submitted Charge Amount | 1102767 |
| Total Medicare Allowed Amount | 167248.59 |
| Total Medicare Payment Amount | 123763.08 |
| Total Medicare Standardized Payment Amount | 130653.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 6472 |
| Number Of Medicare Beneficiaries With Medical Services | 4663 |
| Total Medical Submitted Charge Amount | 1102767 |
| Total Medical Medicare Allowed Amount | 167248.59 |
| Total Medical Medicare Payment Amount | 123763.08 |
| Total Medical Medicare Standardized Payment Amount | 130653.55 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 669 |
| Number Of Beneficiaries Age 65 to 74 | 1948 |
| Number Of Beneficiaries Age 75 to 84 | 1341 |
| Number Of Beneficiaries Age Greater 84 | 705 |
| Number Of Female Beneficiaries | 2758 |
| Number Of Male Beneficiaries | 1905 |
| Number Of Non Hispanic White Beneficiaries | 3372 |
| Number Of Black or African American Beneficiaries | 1171 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4020 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 643 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6106 |