National Provider Identifier [NPI]: |
1265493175 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ELIOT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53792 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
561 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
119034 |
Total Medicare Allowed Amount |
36400.21 |
Total Medicare Payment Amount |
27794.04 |
Total Medicare Standardized Payment Amount |
28859.82 |
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 |
35 |
Number Of Medical Services |
561 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
119034 |
Total Medical Medicare Allowed Amount |
36400.21 |
Total Medical Medicare Payment Amount |
27794.04 |
Total Medical Medicare Standardized Payment Amount |
28859.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
192 |
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.2595 |