| National Provider Identifier [NPI]: | 1679676258 |
| Last Name Of The Provider | KALICHMAN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 560 GAGE BLVD STE 101 |
| Street Address 2 Of The Provider | KADLEC CLINIC SOUTH RICHLAND PRIMARY CARE |
| City Of The Provider | RICHLAND |
| Zip Code Of The Provider | 993529531 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1782 |
| Number Of Medicare Beneficiaries | 692 |
| Total Submitted Charge Amount | 389636.5 |
| Total Medicare Allowed Amount | 176218.62 |
| Total Medicare Payment Amount | 125461.8 |
| Total Medicare Standardized Payment Amount | 128499.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1792 |
| Total Drug Medicare AllowedAmount | 1202.01 |
| Total Drug Medicare PaymentAmount | 966.93 |
| Total Drug Medicare Standardized Payment Amount | 966.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 1681 |
| Number Of Medicare Beneficiaries With Medical Services | 691 |
| Total Medical Submitted Charge Amount | 387844.5 |
| Total Medical Medicare Allowed Amount | 175016.61 |
| Total Medical Medicare Payment Amount | 124494.87 |
| Total Medical Medicare Standardized Payment Amount | 127532.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 263 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 359 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 654 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4936 |