| National Provider Identifier [NPI]: | 1003883612 |
| Last Name Of The Provider | KAISER |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1007 GREENFIELD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TIFTON |
| Zip Code Of The Provider | 317943795 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 209 |
| Number Of Services | 6259 |
| Number Of Medicare Beneficiaries | 1248 |
| Total Submitted Charge Amount | 2357546.36 |
| Total Medicare Allowed Amount | 655797.76 |
| Total Medicare Payment Amount | 508679.64 |
| Total Medicare Standardized Payment Amount | 541467.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3106 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 7444 |
| Total Drug Medicare AllowedAmount | 1408.95 |
| Total Drug Medicare PaymentAmount | 1104.61 |
| Total Drug Medicare Standardized Payment Amount | 1104.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 202 |
| Number Of Medical Services | 3153 |
| Number Of Medicare Beneficiaries With Medical Services | 1248 |
| Total Medical Submitted Charge Amount | 2350102.36 |
| Total Medical Medicare Allowed Amount | 654388.81 |
| Total Medical Medicare Payment Amount | 507575.03 |
| Total Medical Medicare Standardized Payment Amount | 540362.94 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 284 |
| Number Of Beneficiaries Age 65 to 74 | 476 |
| Number Of Beneficiaries Age 75 to 84 | 375 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 703 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 964 |
| Number Of Black or African American Beneficiaries | 263 |
| 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 | 761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 487 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4169 |