| National Provider Identifier [NPI]: | 1144311663 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3 MEDICAL PARK DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRHOPE |
| Zip Code Of The Provider | 36532 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 35130 |
| Number Of Medicare Beneficiaries | 1147 |
| Total Submitted Charge Amount | 2228933 |
| Total Medicare Allowed Amount | 1368438.43 |
| Total Medicare Payment Amount | 1044581.11 |
| Total Medicare Standardized Payment Amount | 1067230.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 30988 |
| Number Of Medicare Beneficiaries With Drug Services | 276 |
| Total Drug Submitted ChargeAmount | 1720116 |
| Total Drug Medicare AllowedAmount | 1058164.07 |
| Total Drug Medicare PaymentAmount | 822403.11 |
| Total Drug Medicare Standardized Payment Amount | 822403.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 4142 |
| Number Of Medicare Beneficiaries With Medical Services | 1147 |
| Total Medical Submitted Charge Amount | 508817 |
| Total Medical Medicare Allowed Amount | 310274.36 |
| Total Medical Medicare Payment Amount | 222178 |
| Total Medical Medicare Standardized Payment Amount | 244827.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 506 |
| Number Of Beneficiaries Age 75 to 84 | 336 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 857 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 1060 |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | 1043 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1502 |