National Provider Identifier [NPI]: |
1548219272 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
205 MARENGO ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLORENCE |
Zip Code Of The Provider |
356306033 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
571 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
467401.9 |
Total Medicare Allowed Amount |
71651.08 |
Total Medicare Payment Amount |
55451.91 |
Total Medicare Standardized Payment Amount |
59095.52 |
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 |
78 |
Number Of Medical Services |
571 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
467401.9 |
Total Medical Medicare Allowed Amount |
71651.08 |
Total Medical Medicare Payment Amount |
55451.91 |
Total Medical Medicare Standardized Payment Amount |
59095.52 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
429 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.558 |