| National Provider Identifier [NPI]: | 1609956465 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 SOTOYOME ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954054823 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 9082 |
| Number Of Medicare Beneficiaries | 3864 |
| Total Submitted Charge Amount | 395452 |
| Total Medicare Allowed Amount | 191499.23 |
| Total Medicare Payment Amount | 136871.74 |
| Total Medicare Standardized Payment Amount | 133907.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3114 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 6228 |
| Total Drug Medicare AllowedAmount | 538.72 |
| Total Drug Medicare PaymentAmount | 422.26 |
| Total Drug Medicare Standardized Payment Amount | 422.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 5968 |
| Number Of Medicare Beneficiaries With Medical Services | 3864 |
| Total Medical Submitted Charge Amount | 389224 |
| Total Medical Medicare Allowed Amount | 190960.51 |
| Total Medical Medicare Payment Amount | 136449.48 |
| Total Medical Medicare Standardized Payment Amount | 133484.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 567 |
| Number Of Beneficiaries Age 65 to 74 | 1387 |
| Number Of Beneficiaries Age 75 to 84 | 1079 |
| Number Of Beneficiaries Age Greater 84 | 831 |
| Number Of Female Beneficiaries | 2262 |
| Number Of Male Beneficiaries | 1602 |
| Number Of Non Hispanic White Beneficiaries | 3369 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | 281 |
| Number Of American Indian Alaska Native Beneficiaries | 50 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2863 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1001 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5786 |