National Provider Identifier [NPI]: |
1528291697 |
Last Name Of The Provider |
MCWILLIAMS |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
AA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2165 HERSCHEL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322043819 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiologist Assistants |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
195 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
216956.7 |
Total Medicare Allowed Amount |
36441.4 |
Total Medicare Payment Amount |
28537.13 |
Total Medicare Standardized Payment Amount |
27765.5 |
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 |
43 |
Number Of Medical Services |
195 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
216956.7 |
Total Medical Medicare Allowed Amount |
36441.4 |
Total Medical Medicare Payment Amount |
28537.13 |
Total Medical Medicare Standardized Payment Amount |
27765.5 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
163 |
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6884 |