| National Provider Identifier [NPI]: | 1861578965 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 218 SW 26TH AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | MINERAL WELLS |
| Zip Code Of The Provider | 760678248 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 3911 |
| Number Of Medicare Beneficiaries | 933 |
| Total Submitted Charge Amount | 338217.06 |
| Total Medicare Allowed Amount | 234216.44 |
| Total Medicare Payment Amount | 168917.24 |
| Total Medicare Standardized Payment Amount | 179749.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 485 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 5478 |
| Total Drug Medicare AllowedAmount | 1497.15 |
| Total Drug Medicare PaymentAmount | 1103.16 |
| Total Drug Medicare Standardized Payment Amount | 1103.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 3426 |
| Number Of Medicare Beneficiaries With Medical Services | 933 |
| Total Medical Submitted Charge Amount | 332739.06 |
| Total Medical Medicare Allowed Amount | 232719.29 |
| Total Medical Medicare Payment Amount | 167814.08 |
| Total Medical Medicare Standardized Payment Amount | 178646.23 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 309 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 369 |
| Number Of Non Hispanic White Beneficiaries | 876 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 676 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5582 |