National Provider Identifier [NPI]: |
1033443239 |
Last Name Of The Provider |
WILLIAMSON |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
LPT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7233 WHIPPLE AVE NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH CANTON |
Zip Code Of The Provider |
447207137 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
996 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
47245 |
Total Medicare Allowed Amount |
28571.49 |
Total Medicare Payment Amount |
21574.44 |
Total Medicare Standardized Payment Amount |
16294.69 |
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 |
13 |
Number Of Medical Services |
996 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
47245 |
Total Medical Medicare Allowed Amount |
28571.49 |
Total Medical Medicare Payment Amount |
21574.44 |
Total Medical Medicare Standardized Payment Amount |
16294.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
13 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
34 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8623 |