| National Provider Identifier [NPI]: | 1689867897 |
| Last Name Of The Provider | HILTZ |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 630 13TH STREET |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 309011017 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 15766 |
| Number Of Medicare Beneficiaries | 1185 |
| Total Submitted Charge Amount | 2771426 |
| Total Medicare Allowed Amount | 660921.66 |
| Total Medicare Payment Amount | 510854.69 |
| Total Medicare Standardized Payment Amount | 561828.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 12825 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 12825 |
| Total Drug Medicare AllowedAmount | 2415.53 |
| Total Drug Medicare PaymentAmount | 1880.25 |
| Total Drug Medicare Standardized Payment Amount | 1880.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 2941 |
| Number Of Medicare Beneficiaries With Medical Services | 1185 |
| Total Medical Submitted Charge Amount | 2758601 |
| Total Medical Medicare Allowed Amount | 658506.13 |
| Total Medical Medicare Payment Amount | 508974.44 |
| Total Medical Medicare Standardized Payment Amount | 559947.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 658 |
| Number Of Male Beneficiaries | 527 |
| Number Of Non Hispanic White Beneficiaries | 731 |
| Number Of Black or African American Beneficiaries | 428 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 857 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.4552 |