| National Provider Identifier [NPI]: | 1154574390 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | BRICE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4403 HARRISON BLVD. |
| Street Address 2 Of The Provider | SUITE 3600 |
| City Of The Provider | OGDEN |
| Zip Code Of The Provider | 844033285 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 3996 |
| Number Of Medicare Beneficiaries | 952 |
| Total Submitted Charge Amount | 1267957 |
| Total Medicare Allowed Amount | 675923.62 |
| Total Medicare Payment Amount | 498487.2 |
| Total Medicare Standardized Payment Amount | 511680.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 631 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 277140 |
| Total Drug Medicare AllowedAmount | 201351.18 |
| Total Drug Medicare PaymentAmount | 157488.03 |
| Total Drug Medicare Standardized Payment Amount | 157488.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3365 |
| Number Of Medicare Beneficiaries With Medical Services | 952 |
| Total Medical Submitted Charge Amount | 990817 |
| Total Medical Medicare Allowed Amount | 474572.44 |
| Total Medical Medicare Payment Amount | 340999.17 |
| Total Medical Medicare Standardized Payment Amount | 354192.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 405 |
| Number Of Beneficiaries Age 75 to 84 | 329 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 552 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 870 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 873 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0641 |