| National Provider Identifier [NPI]: | 1609872332 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6850 HOHMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAMMOND |
| Zip Code Of The Provider | 463241410 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 7288 |
| Number Of Medicare Beneficiaries | 3304 |
| Total Submitted Charge Amount | 3644295 |
| Total Medicare Allowed Amount | 1136017.54 |
| Total Medicare Payment Amount | 811612.69 |
| Total Medicare Standardized Payment Amount | 879899.91 |
| 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 | 31 |
| Number Of Medical Services | 7288 |
| Number Of Medicare Beneficiaries With Medical Services | 3304 |
| Total Medical Submitted Charge Amount | 3644295 |
| Total Medical Medicare Allowed Amount | 1136017.54 |
| Total Medical Medicare Payment Amount | 811612.69 |
| Total Medical Medicare Standardized Payment Amount | 879899.91 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 1207 |
| Number Of Beneficiaries Age 75 to 84 | 1325 |
| Number Of Beneficiaries Age Greater 84 | 644 |
| Number Of Female Beneficiaries | 1964 |
| Number Of Male Beneficiaries | 1340 |
| Number Of Non Hispanic White Beneficiaries | 2721 |
| Number Of Black or African American Beneficiaries | 307 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 229 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3093 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 211 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1593 |