| National Provider Identifier [NPI]: | 1669526315 |
| Last Name Of The Provider | ESCOFFERY |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 339 RACETRACK RD NW |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | FORT WALTON BEACH |
| Zip Code Of The Provider | 325471538 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 709 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 341787 |
| Total Medicare Allowed Amount | 74691.91 |
| Total Medicare Payment Amount | 51595.17 |
| Total Medicare Standardized Payment Amount | 52113.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 3647 |
| Total Drug Medicare AllowedAmount | 39.21 |
| Total Drug Medicare PaymentAmount | 30.77 |
| Total Drug Medicare Standardized Payment Amount | 30.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 660 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 338140 |
| Total Medical Medicare Allowed Amount | 74652.7 |
| Total Medical Medicare Payment Amount | 51564.4 |
| Total Medical Medicare Standardized Payment Amount | 52082.69 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 132 |
| Number Of Black or African American Beneficiaries | |
| 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 | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.071 |