National Provider Identifier [NPI]: |
1982694162 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1758 PARK PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361061133 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
6412 |
Number Of Medicare Beneficiaries |
1399 |
Total Submitted Charge Amount |
1759496 |
Total Medicare Allowed Amount |
596663.77 |
Total Medicare Payment Amount |
445996.57 |
Total Medicare Standardized Payment Amount |
479244.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
709 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
11376 |
Total Drug Medicare AllowedAmount |
1190.23 |
Total Drug Medicare PaymentAmount |
918.3 |
Total Drug Medicare Standardized Payment Amount |
918.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
5703 |
Number Of Medicare Beneficiaries With Medical Services |
1399 |
Total Medical Submitted Charge Amount |
1748120 |
Total Medical Medicare Allowed Amount |
595473.54 |
Total Medical Medicare Payment Amount |
445078.27 |
Total Medical Medicare Standardized Payment Amount |
478326.05 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
491 |
Number Of Beneficiaries Age 75 to 84 |
528 |
Number Of Beneficiaries Age Greater 84 |
239 |
Number Of Female Beneficiaries |
679 |
Number Of Male Beneficiaries |
720 |
Number Of Non Hispanic White Beneficiaries |
1203 |
Number Of Black or African American Beneficiaries |
181 |
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 |
1238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.4001 |