| National Provider Identifier [NPI]: | 1225135031 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | KEDRA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 DUNN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322186330 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 4802 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 343153.5 |
| Total Medicare Allowed Amount | 146578.61 |
| Total Medicare Payment Amount | 113871.04 |
| Total Medicare Standardized Payment Amount | 115858.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 214 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 8217 |
| Total Drug Medicare AllowedAmount | 3828.35 |
| Total Drug Medicare PaymentAmount | 3707.91 |
| Total Drug Medicare Standardized Payment Amount | 3707.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 4588 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 334936.5 |
| Total Medical Medicare Allowed Amount | 142750.26 |
| Total Medical Medicare Payment Amount | 110163.13 |
| Total Medical Medicare Standardized Payment Amount | 112150.72 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 125 |
| Number Of Black or African American Beneficiaries | 206 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 250 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3327 |