National Provider Identifier [NPI]: |
1245246354 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23077 GREENFIELD RD |
Street Address 2 Of The Provider |
STE 231 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480753709 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
357 |
Total Submitted Charge Amount |
193669.99 |
Total Medicare Allowed Amount |
97505.13 |
Total Medicare Payment Amount |
76877.91 |
Total Medicare Standardized Payment Amount |
74404.7 |
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 |
26 |
Number Of Medical Services |
572 |
Number Of Medicare Beneficiaries With Medical Services |
357 |
Total Medical Submitted Charge Amount |
193669.99 |
Total Medical Medicare Allowed Amount |
97505.13 |
Total Medical Medicare Payment Amount |
76877.91 |
Total Medical Medicare Standardized Payment Amount |
74404.7 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
288 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9425 |