National Provider Identifier [NPI]: |
1902855794 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3107 BAY RIDGE CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRIENDSWOOD |
Zip Code Of The Provider |
775464982 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
287 |
Number Of Medicare Beneficiaries |
189 |
Total Submitted Charge Amount |
99947 |
Total Medicare Allowed Amount |
28056.37 |
Total Medicare Payment Amount |
21546 |
Total Medicare Standardized Payment Amount |
22326.4 |
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 |
12 |
Number Of Medical Services |
287 |
Number Of Medicare Beneficiaries With Medical Services |
189 |
Total Medical Submitted Charge Amount |
99947 |
Total Medical Medicare Allowed Amount |
28056.37 |
Total Medical Medicare Payment Amount |
21546 |
Total Medical Medicare Standardized Payment Amount |
22326.4 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
104 |
Number Of Black or African American Beneficiaries |
70 |
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 |
110 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.793 |