| National Provider Identifier [NPI]: | 1003842071 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PHD, MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 61 MEMORIAL MEDICAL PKWY |
| Street Address 2 Of The Provider | SUITE 3806 |
| City Of The Provider | PALM COAST |
| Zip Code Of The Provider | 321645981 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 5159 |
| Number Of Medicare Beneficiaries | 524 |
| Total Submitted Charge Amount | 744696.01 |
| Total Medicare Allowed Amount | 496474.88 |
| Total Medicare Payment Amount | 381524.8 |
| Total Medicare Standardized Payment Amount | 374479.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1160 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 19620 |
| Total Drug Medicare AllowedAmount | 13262.83 |
| Total Drug Medicare PaymentAmount | 9982.41 |
| Total Drug Medicare Standardized Payment Amount | 9982.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 3999 |
| Number Of Medicare Beneficiaries With Medical Services | 524 |
| Total Medical Submitted Charge Amount | 725076.01 |
| Total Medical Medicare Allowed Amount | 483212.05 |
| Total Medical Medicare Payment Amount | 371542.39 |
| Total Medical Medicare Standardized Payment Amount | 364497.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 388 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.7344 |