| National Provider Identifier [NPI]: | 1962472464 |
| Last Name Of The Provider | WILLEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19829 N 27TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850274001 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 3889 |
| Number Of Medicare Beneficiaries | 2690 |
| Total Submitted Charge Amount | 488573.53 |
| Total Medicare Allowed Amount | 121615.31 |
| Total Medicare Payment Amount | 94273.78 |
| Total Medicare Standardized Payment Amount | 95273.63 |
| 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 | 188 |
| Number Of Medical Services | 3889 |
| Number Of Medicare Beneficiaries With Medical Services | 2690 |
| Total Medical Submitted Charge Amount | 488573.53 |
| Total Medical Medicare Allowed Amount | 121615.31 |
| Total Medical Medicare Payment Amount | 94273.78 |
| Total Medical Medicare Standardized Payment Amount | 95273.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 421 |
| Number Of Beneficiaries Age 65 to 74 | 1077 |
| Number Of Beneficiaries Age 75 to 84 | 830 |
| Number Of Beneficiaries Age Greater 84 | 362 |
| Number Of Female Beneficiaries | 1524 |
| Number Of Male Beneficiaries | 1166 |
| Number Of Non Hispanic White Beneficiaries | 2034 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 377 |
| Number Of American Indian Alaska Native Beneficiaries | 160 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2010 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 680 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6068 |