| National Provider Identifier [NPI]: | 1902855281 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 10471 |
| Number Of Medicare Beneficiaries | 3563 |
| Total Submitted Charge Amount | 946032.5 |
| Total Medicare Allowed Amount | 224810.91 |
| Total Medicare Payment Amount | 171595.77 |
| Total Medicare Standardized Payment Amount | 175198.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 4989 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 28624 |
| Total Drug Medicare AllowedAmount | 8060.68 |
| Total Drug Medicare PaymentAmount | 5042.14 |
| Total Drug Medicare Standardized Payment Amount | 5042.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 5482 |
| Number Of Medicare Beneficiaries With Medical Services | 3562 |
| Total Medical Submitted Charge Amount | 917408.5 |
| Total Medical Medicare Allowed Amount | 216750.23 |
| Total Medical Medicare Payment Amount | 166553.63 |
| Total Medical Medicare Standardized Payment Amount | 170156.7 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 648 |
| Number Of Beneficiaries Age 65 to 74 | 1350 |
| Number Of Beneficiaries Age 75 to 84 | 1006 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 2047 |
| Number Of Male Beneficiaries | 1516 |
| Number Of Non Hispanic White Beneficiaries | 2592 |
| Number Of Black or African American Beneficiaries | 352 |
| Number Of AsianPacific Islander Beneficiaries | 77 |
| Number Of Hispanic Beneficiaries | 484 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 864 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9435 |