| National Provider Identifier [NPI]: | 1619084704 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2222 S HARBOR CITY BLVD |
| Street Address 2 Of The Provider | SUITE 520 |
| City Of The Provider | MELBOURNE |
| Zip Code Of The Provider | 329015594 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 139 |
| Number Of Services | 4080 |
| Number Of Medicare Beneficiaries | 2520 |
| Total Submitted Charge Amount | 4043857.5 |
| Total Medicare Allowed Amount | 723341.5 |
| Total Medicare Payment Amount | 547667.4 |
| Total Medicare Standardized Payment Amount | 577974.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 267 |
| Number Of Medicare Beneficiaries With Drug Services | 245 |
| Total Drug Submitted ChargeAmount | 6330 |
| Total Drug Medicare AllowedAmount | 359.39 |
| Total Drug Medicare PaymentAmount | 276.29 |
| Total Drug Medicare Standardized Payment Amount | 276.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 3813 |
| Number Of Medicare Beneficiaries With Medical Services | 2520 |
| Total Medical Submitted Charge Amount | 4037527.5 |
| Total Medical Medicare Allowed Amount | 722982.11 |
| Total Medical Medicare Payment Amount | 547391.11 |
| Total Medical Medicare Standardized Payment Amount | 577698.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 432 |
| Number Of Beneficiaries Age 65 to 74 | 1095 |
| Number Of Beneficiaries Age 75 to 84 | 747 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 1497 |
| Number Of Male Beneficiaries | 1023 |
| Number Of Non Hispanic White Beneficiaries | 2140 |
| Number Of Black or African American Beneficiaries | 192 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1706 |