| National Provider Identifier [NPI]: | 1558328161 |
| Last Name Of The Provider | BASTNAGEL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1910 NONCONNAH BLVD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381322113 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1105 |
| Number Of Medicare Beneficiaries | 812 |
| Total Submitted Charge Amount | 338470 |
| Total Medicare Allowed Amount | 124222.27 |
| Total Medicare Payment Amount | 94079.8 |
| Total Medicare Standardized Payment Amount | 99172.7 |
| 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 | 25 |
| Number Of Medical Services | 1105 |
| Number Of Medicare Beneficiaries With Medical Services | 812 |
| Total Medical Submitted Charge Amount | 338470 |
| Total Medical Medicare Allowed Amount | 124222.27 |
| Total Medical Medicare Payment Amount | 94079.8 |
| Total Medical Medicare Standardized Payment Amount | 99172.7 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 278 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 504 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| Number Of Black or African American Beneficiaries | 540 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 430 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.6226 |