| National Provider Identifier [NPI]: | 1720157654 |
| Last Name Of The Provider | VINES |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 266 JOULE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALCOA |
| Zip Code Of The Provider | 377012422 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 2938 |
| Number Of Medicare Beneficiaries | 481 |
| Total Submitted Charge Amount | 202191.83 |
| Total Medicare Allowed Amount | 128232.19 |
| Total Medicare Payment Amount | 92569.33 |
| Total Medicare Standardized Payment Amount | 99515.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 1171 |
| Number Of Medicare Beneficiaries With Drug Services | 229 |
| Total Drug Submitted ChargeAmount | 46728.57 |
| Total Drug Medicare AllowedAmount | 22853.36 |
| Total Drug Medicare PaymentAmount | 20187.68 |
| Total Drug Medicare Standardized Payment Amount | 20187.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1767 |
| Number Of Medicare Beneficiaries With Medical Services | 481 |
| Total Medical Submitted Charge Amount | 155463.26 |
| Total Medical Medicare Allowed Amount | 105378.83 |
| Total Medical Medicare Payment Amount | 72381.65 |
| Total Medical Medicare Standardized Payment Amount | 79327.93 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 470 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9986 |