| National Provider Identifier [NPI]: | 1376545293 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12 PROFESSIONAL PARK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEBSTER |
| Zip Code Of The Provider | 775984127 |
| 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 | 59 |
| Number Of Services | 11388 |
| Number Of Medicare Beneficiaries | 1989 |
| Total Submitted Charge Amount | 559390.53 |
| Total Medicare Allowed Amount | 532639.48 |
| Total Medicare Payment Amount | 376837.41 |
| Total Medicare Standardized Payment Amount | 370208.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 14953.86 |
| Total Drug Medicare AllowedAmount | 14777.04 |
| Total Drug Medicare PaymentAmount | 11567.95 |
| Total Drug Medicare Standardized Payment Amount | 11567.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 11271 |
| Number Of Medicare Beneficiaries With Medical Services | 1989 |
| Total Medical Submitted Charge Amount | 544436.67 |
| Total Medical Medicare Allowed Amount | 517862.44 |
| Total Medical Medicare Payment Amount | 365269.46 |
| Total Medical Medicare Standardized Payment Amount | 358640.29 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 920 |
| Number Of Beneficiaries Age 75 to 84 | 686 |
| Number Of Beneficiaries Age Greater 84 | 307 |
| Number Of Female Beneficiaries | 797 |
| Number Of Male Beneficiaries | 1192 |
| Number Of Non Hispanic White Beneficiaries | 1859 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1925 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.006 |