National Provider Identifier [NPI]: |
1770507931 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
SIDNEY |
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 |
801 S WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
STILLWATER |
Zip Code Of The Provider |
740744541 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
25957 |
Number Of Medicare Beneficiaries |
469 |
Total Submitted Charge Amount |
602588.25 |
Total Medicare Allowed Amount |
423198.33 |
Total Medicare Payment Amount |
332820.09 |
Total Medicare Standardized Payment Amount |
358834.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
997 |
Number Of Medicare Beneficiaries With Drug Services |
252 |
Total Drug Submitted ChargeAmount |
18541 |
Total Drug Medicare AllowedAmount |
4301.52 |
Total Drug Medicare PaymentAmount |
3558.22 |
Total Drug Medicare Standardized Payment Amount |
3558.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
24960 |
Number Of Medicare Beneficiaries With Medical Services |
469 |
Total Medical Submitted Charge Amount |
584047.25 |
Total Medical Medicare Allowed Amount |
418896.81 |
Total Medical Medicare Payment Amount |
329261.87 |
Total Medical Medicare Standardized Payment Amount |
355276.08 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
215 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
260 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
423 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
19 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
292 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5973 |