| National Provider Identifier [NPI]: | 1861779795 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | OLIVER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | LCSW |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14400 JOHN HUMPHREY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLAND PARK |
| Zip Code Of The Provider | 604622897 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Licensed Clinical Social Worker |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 1886 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 121130 |
| Total Medicare Allowed Amount | 44066.91 |
| Total Medicare Payment Amount | 34354.05 |
| Total Medicare Standardized Payment Amount | 32302 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 1886 |
| Number Of Medicare Beneficiaries With Medical Services | 262 |
| Total Medical Submitted Charge Amount | 121130 |
| Total Medical Medicare Allowed Amount | 44066.91 |
| Total Medical Medicare Payment Amount | 34354.05 |
| Total Medical Medicare Standardized Payment Amount | 32302 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 113 |
| Number Of Black or African American Beneficiaries | 126 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 68 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9587 |