| National Provider Identifier [NPI]: | 1336239979 |
| Last Name Of The Provider | WAY |
| First Name Of The Provider | BILL |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 706 W CENTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUNCANVILLE |
| Zip Code Of The Provider | 751164568 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5802 |
| Number Of Medicare Beneficiaries | 1058 |
| Total Submitted Charge Amount | 387250.1 |
| Total Medicare Allowed Amount | 359581.36 |
| Total Medicare Payment Amount | 256451.12 |
| Total Medicare Standardized Payment Amount | 253258.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 4500 |
| Total Drug Medicare AllowedAmount | 4456.6 |
| Total Drug Medicare PaymentAmount | 3473.26 |
| Total Drug Medicare Standardized Payment Amount | 3473.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5784 |
| Number Of Medicare Beneficiaries With Medical Services | 1058 |
| Total Medical Submitted Charge Amount | 382750.1 |
| Total Medical Medicare Allowed Amount | 355124.76 |
| Total Medical Medicare Payment Amount | 252977.86 |
| Total Medical Medicare Standardized Payment Amount | 249784.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 412 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 586 |
| Number Of Male Beneficiaries | 472 |
| Number Of Non Hispanic White Beneficiaries | 753 |
| Number Of Black or African American Beneficiaries | 213 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 832 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 226 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.31 |