National Provider Identifier [NPI]: |
1356437693 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
DIONE |
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 |
1787 SPRINGFIELD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAPLEWOOD |
Zip Code Of The Provider |
07040 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
899 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
369804 |
Total Medicare Allowed Amount |
106890.78 |
Total Medicare Payment Amount |
81600.67 |
Total Medicare Standardized Payment Amount |
72787.33 |
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 |
29 |
Number Of Medical Services |
899 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
369804 |
Total Medical Medicare Allowed Amount |
106890.78 |
Total Medical Medicare Payment Amount |
81600.67 |
Total Medical Medicare Standardized Payment Amount |
72787.33 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
24 |
Number Of Black or African American Beneficiaries |
203 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9884 |