| National Provider Identifier [NPI]: | 1609872068 |
| Last Name Of The Provider | SHACHTMAN |
| First Name Of The Provider | WILLIAM |
| 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 | 1725 E PROSPECT ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805251307 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1702 |
| Number Of Medicare Beneficiaries | 1054 |
| Total Submitted Charge Amount | 213875 |
| Total Medicare Allowed Amount | 168799.87 |
| Total Medicare Payment Amount | 108918.71 |
| Total Medicare Standardized Payment Amount | 108696.28 |
| 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 | 1702 |
| Number Of Medicare Beneficiaries With Medical Services | 1054 |
| Total Medical Submitted Charge Amount | 213875 |
| Total Medical Medicare Allowed Amount | 168799.87 |
| Total Medical Medicare Payment Amount | 108918.71 |
| Total Medical Medicare Standardized Payment Amount | 108696.28 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 450 |
| Number Of Beneficiaries Age 75 to 84 | 336 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 632 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 996 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1010 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 6 |
| 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 | 0.9037 |