| National Provider Identifier [NPI]: | 1720021744 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7277 SMITHS MILL RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | NEW ALBANY |
| Zip Code Of The Provider | 430548195 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 5491 |
| Number Of Medicare Beneficiaries | 987 |
| Total Submitted Charge Amount | 364070.22 |
| Total Medicare Allowed Amount | 124389.46 |
| Total Medicare Payment Amount | 90084.64 |
| Total Medicare Standardized Payment Amount | 101236.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3288 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 63172.5 |
| Total Drug Medicare AllowedAmount | 40446.82 |
| Total Drug Medicare PaymentAmount | 31431.26 |
| Total Drug Medicare Standardized Payment Amount | 31431.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2203 |
| Number Of Medicare Beneficiaries With Medical Services | 987 |
| Total Medical Submitted Charge Amount | 300897.72 |
| Total Medical Medicare Allowed Amount | 83942.64 |
| Total Medical Medicare Payment Amount | 58653.38 |
| Total Medical Medicare Standardized Payment Amount | 69805.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 537 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 578 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 919 |
| Number Of Black or African American Beneficiaries | 39 |
| 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 | 918 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9488 |