National Provider Identifier [NPI]: |
1912986217 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
SABRINA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4880 CENTURY PLAZA WAY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462545474 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
962 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
71321 |
Total Medicare Allowed Amount |
47916.74 |
Total Medicare Payment Amount |
30298.34 |
Total Medicare Standardized Payment Amount |
32813.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
2849 |
Total Drug Medicare AllowedAmount |
2159.59 |
Total Drug Medicare PaymentAmount |
2095.94 |
Total Drug Medicare Standardized Payment Amount |
2095.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
891 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
68472 |
Total Medical Medicare Allowed Amount |
45757.15 |
Total Medical Medicare Payment Amount |
28202.4 |
Total Medical Medicare Standardized Payment Amount |
30717.77 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
119 |
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 |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1977 |