| National Provider Identifier [NPI]: | 1588696553 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12995 S CLEVELAND AVE STE 184 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339077703 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 6291 |
| Number Of Medicare Beneficiaries | 774 |
| Total Submitted Charge Amount | 460111.82 |
| Total Medicare Allowed Amount | 291797.69 |
| Total Medicare Payment Amount | 210342.06 |
| Total Medicare Standardized Payment Amount | 204049.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 3077 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 71676.06 |
| Total Drug Medicare AllowedAmount | 48643.25 |
| Total Drug Medicare PaymentAmount | 40026.23 |
| Total Drug Medicare Standardized Payment Amount | 40026.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 3214 |
| Number Of Medicare Beneficiaries With Medical Services | 774 |
| Total Medical Submitted Charge Amount | 388435.76 |
| Total Medical Medicare Allowed Amount | 243154.44 |
| Total Medical Medicare Payment Amount | 170315.83 |
| Total Medical Medicare Standardized Payment Amount | 164023.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 460 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 733 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 743 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9562 |