| National Provider Identifier [NPI]: | 1255494969 |
| Last Name Of The Provider | WILLIS |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4600 E SAM HOUSTON PKWY S |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 775053948 |
| 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 | 124 |
| Number Of Services | 7373 |
| Number Of Medicare Beneficiaries | 1605 |
| Total Submitted Charge Amount | 270754.41 |
| Total Medicare Allowed Amount | 90609.59 |
| Total Medicare Payment Amount | 67163.29 |
| Total Medicare Standardized Payment Amount | 67631.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5087 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 4782.13 |
| Total Drug Medicare AllowedAmount | 1011.82 |
| Total Drug Medicare PaymentAmount | 793.3 |
| Total Drug Medicare Standardized Payment Amount | 793.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 2286 |
| Number Of Medicare Beneficiaries With Medical Services | 1605 |
| Total Medical Submitted Charge Amount | 265972.28 |
| Total Medical Medicare Allowed Amount | 89597.77 |
| Total Medical Medicare Payment Amount | 66369.99 |
| Total Medical Medicare Standardized Payment Amount | 66838.56 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 507 |
| Number Of Beneficiaries Age 65 to 74 | 615 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 979 |
| Number Of Male Beneficiaries | 626 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | 606 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 333 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 914 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 691 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9295 |