| National Provider Identifier [NPI]: | 1598744393 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2821 SEABREEZE DR S |
| Street Address 2 Of The Provider | |
| City Of The Provider | GULFPORT |
| Zip Code Of The Provider | 337073931 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 23862 |
| Number Of Medicare Beneficiaries | 6150 |
| Total Submitted Charge Amount | 5169025.93 |
| Total Medicare Allowed Amount | 2418578.1 |
| Total Medicare Payment Amount | 1879872.13 |
| Total Medicare Standardized Payment Amount | 1497096.19 |
| 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 | 22 |
| Number Of Medical Services | 23862 |
| Number Of Medicare Beneficiaries With Medical Services | 6150 |
| Total Medical Submitted Charge Amount | 5169025.93 |
| Total Medical Medicare Allowed Amount | 2418578.1 |
| Total Medical Medicare Payment Amount | 1879872.13 |
| Total Medical Medicare Standardized Payment Amount | 1497096.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 501 |
| Number Of Beneficiaries Age 65 to 74 | 2811 |
| Number Of Beneficiaries Age 75 to 84 | 2096 |
| Number Of Beneficiaries Age Greater 84 | 742 |
| Number Of Female Beneficiaries | 2726 |
| Number Of Male Beneficiaries | 3424 |
| Number Of Non Hispanic White Beneficiaries | 5683 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 159 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 90 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5604 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 546 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1902 |