| National Provider Identifier [NPI]: | 1255383212 |
| Last Name Of The Provider | WILLER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 CHERRY HEIGHTS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | THE DALLES |
| Zip Code Of The Provider | 970583586 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3618 |
| Number Of Medicare Beneficiaries | 1834 |
| Total Submitted Charge Amount | 662654 |
| Total Medicare Allowed Amount | 535014.7 |
| Total Medicare Payment Amount | 376723.57 |
| Total Medicare Standardized Payment Amount | 395350.85 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 721 |
| Number Of Beneficiaries Age 75 to 84 | 668 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 1113 |
| Number Of Male Beneficiaries | 721 |
| Number Of Non Hispanic White Beneficiaries | 1726 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1561 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8968 |