| National Provider Identifier [NPI]: | 1326024076 |
| Last Name Of The Provider | WILLIS |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5303 PLAZA DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | HOPEWELL |
| Zip Code Of The Provider | 238607331 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 554 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 41488.24 |
| Total Medicare Allowed Amount | 16596.19 |
| Total Medicare Payment Amount | 11297.53 |
| Total Medicare Standardized Payment Amount | 13931.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 556.24 |
| Total Drug Medicare AllowedAmount | 139.58 |
| Total Drug Medicare PaymentAmount | 91.09 |
| Total Drug Medicare Standardized Payment Amount | 91.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 459 |
| Number Of Medicare Beneficiaries With Medical Services | 170 |
| Total Medical Submitted Charge Amount | 40932 |
| Total Medical Medicare Allowed Amount | 16456.61 |
| Total Medical Medicare Payment Amount | 11206.44 |
| Total Medical Medicare Standardized Payment Amount | 13840.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 113 |
| Number Of Black or African American Beneficiaries | |
| 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 | 156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 0.9564 |