| National Provider Identifier [NPI]: | 1255321790 |
| Last Name Of The Provider | WILLIS |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | P |
| 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 | 206 |
| Number Of Services | 8437 |
| Number Of Medicare Beneficiaries | 3349 |
| Total Submitted Charge Amount | 632528.8 |
| Total Medicare Allowed Amount | 176862.61 |
| Total Medicare Payment Amount | 137252.26 |
| Total Medicare Standardized Payment Amount | 143408.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2631 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1893.8 |
| Total Drug Medicare AllowedAmount | 585.93 |
| Total Drug Medicare PaymentAmount | 447.87 |
| Total Drug Medicare Standardized Payment Amount | 447.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 204 |
| Number Of Medical Services | 5806 |
| Number Of Medicare Beneficiaries With Medical Services | 3349 |
| Total Medical Submitted Charge Amount | 630635 |
| Total Medical Medicare Allowed Amount | 176276.68 |
| Total Medical Medicare Payment Amount | 136804.39 |
| Total Medical Medicare Standardized Payment Amount | 142960.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 524 |
| Number Of Beneficiaries Age 65 to 74 | 1407 |
| Number Of Beneficiaries Age 75 to 84 | 936 |
| Number Of Beneficiaries Age Greater 84 | 482 |
| Number Of Female Beneficiaries | 2131 |
| Number Of Male Beneficiaries | 1218 |
| Number Of Non Hispanic White Beneficiaries | 2736 |
| Number Of Black or African American Beneficiaries | 208 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 322 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 666 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5909 |