| National Provider Identifier [NPI]: | 1235153461 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10850 E TRAVERSE HWY |
| Street Address 2 Of The Provider | SUITE 60 |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 496841364 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 7368 |
| Number Of Medicare Beneficiaries | 4970 |
| Total Submitted Charge Amount | 712948 |
| Total Medicare Allowed Amount | 246711.33 |
| Total Medicare Payment Amount | 182401.81 |
| Total Medicare Standardized Payment Amount | 188513.6 |
| 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 | 188 |
| Number Of Medical Services | 7368 |
| Number Of Medicare Beneficiaries With Medical Services | 4970 |
| Total Medical Submitted Charge Amount | 712948 |
| Total Medical Medicare Allowed Amount | 246711.33 |
| Total Medical Medicare Payment Amount | 182401.81 |
| Total Medical Medicare Standardized Payment Amount | 188513.6 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 998 |
| Number Of Beneficiaries Age 65 to 74 | 1643 |
| Number Of Beneficiaries Age 75 to 84 | 1482 |
| Number Of Beneficiaries Age Greater 84 | 847 |
| Number Of Female Beneficiaries | 2704 |
| Number Of Male Beneficiaries | 2266 |
| Number Of Non Hispanic White Beneficiaries | 4822 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 53 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3646 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1324 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5352 |