| National Provider Identifier [NPI]: | 1467403733 |
| Last Name Of The Provider | ADAMS |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 RIGBY LAKE DR |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | RIGBY |
| Zip Code Of The Provider | 834425192 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 3800 |
| Number Of Medicare Beneficiaries | 524 |
| Total Submitted Charge Amount | 112291.22 |
| Total Medicare Allowed Amount | 98642.44 |
| Total Medicare Payment Amount | 69072.51 |
| Total Medicare Standardized Payment Amount | 76603.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 1358 |
| Number Of Medicare Beneficiaries With Drug Services | 225 |
| Total Drug Submitted ChargeAmount | 7698.75 |
| Total Drug Medicare AllowedAmount | 3619.35 |
| Total Drug Medicare PaymentAmount | 3227.21 |
| Total Drug Medicare Standardized Payment Amount | 3227.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2442 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 104592.47 |
| Total Medical Medicare Allowed Amount | 95023.09 |
| Total Medical Medicare Payment Amount | 65845.3 |
| Total Medical Medicare Standardized Payment Amount | 73375.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 506 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0209 |