| National Provider Identifier [NPI]: | 1710181961 |
| Last Name Of The Provider | WILLIAMSON |
| First Name Of The Provider | KYLE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 E CAMPUS VIEW BLVD |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432354647 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 6261 |
| Number Of Medicare Beneficiaries | 3867 |
| Total Submitted Charge Amount | 527536 |
| Total Medicare Allowed Amount | 147032.65 |
| Total Medicare Payment Amount | 116314.38 |
| Total Medicare Standardized Payment Amount | 119127.5 |
| 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 | 174 |
| Number Of Medical Services | 6261 |
| Number Of Medicare Beneficiaries With Medical Services | 3867 |
| Total Medical Submitted Charge Amount | 527536 |
| Total Medical Medicare Allowed Amount | 147032.65 |
| Total Medical Medicare Payment Amount | 116314.38 |
| Total Medical Medicare Standardized Payment Amount | 119127.5 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 774 |
| Number Of Beneficiaries Age 65 to 74 | 1443 |
| Number Of Beneficiaries Age 75 to 84 | 1103 |
| Number Of Beneficiaries Age Greater 84 | 547 |
| Number Of Female Beneficiaries | 2487 |
| Number Of Male Beneficiaries | 1380 |
| Number Of Non Hispanic White Beneficiaries | 3548 |
| Number Of Black or African American Beneficiaries | 114 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2858 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1009 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3886 |