| National Provider Identifier [NPI]: | 1902859762 |
| Last Name Of The Provider | WILLETT |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 539 EAST PRUDHOMME ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OPELOUSAS |
| Zip Code Of The Provider | 70570 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 5958 |
| Number Of Medicare Beneficiaries | 3014 |
| Total Submitted Charge Amount | 690156 |
| Total Medicare Allowed Amount | 147884.11 |
| Total Medicare Payment Amount | 114353.3 |
| Total Medicare Standardized Payment Amount | 119446.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 5958 |
| Number Of Medicare Beneficiaries With Medical Services | 3014 |
| Total Medical Submitted Charge Amount | 690156 |
| Total Medical Medicare Allowed Amount | 147884.11 |
| Total Medical Medicare Payment Amount | 114353.3 |
| Total Medical Medicare Standardized Payment Amount | 119446.66 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 799 |
| Number Of Beneficiaries Age 65 to 74 | 1065 |
| Number Of Beneficiaries Age 75 to 84 | 784 |
| Number Of Beneficiaries Age Greater 84 | 366 |
| Number Of Female Beneficiaries | 1849 |
| Number Of Male Beneficiaries | 1165 |
| Number Of Non Hispanic White Beneficiaries | 1753 |
| Number Of Black or African American Beneficiaries | 1222 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1455 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1559 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7587 |