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Dr. Jerrold C Willis

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NPI Number Detailed Information

Provider Information:

Name: Dr. Jerrold C Willis
Gender: M
Provider License Number If Given: 36057038

NPI Information:

NPI: 1467407072
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2006

Last Update Date: 3/15/2021

Reputation Report:

Provider Business Mailing Address:

Address: PO BOX 2153 DEPT 20002
Birmingham, AL 35287
Phone Number: 8774650012
Fax Number: 3034381351

Provider Business Practice Location Address:

Address: 1 GOOD SAMARITAN WAY RADIOLOGY DEPT
Mount Vernon, IL 62864
Phone Number: 6182424600
Fax Number:

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: IL

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About Dr. Jerrold C Willis

Dr. Jerrold C Willis (DR. JERROLD C WILLIS ) is A Radiology Physician in Mount Vernon, IL. The NPI Number for Dr. Jerrold C Willis is 1467407072.
The current location address for Dr. Jerrold C Willis is 1 GOOD SAMARITAN WAY RADIOLOGY DEPT Mount Vernon, IL 62864 and the contact number is 8774650012 and fax number is 3034381351. The mailing address for Dr. Jerrold C Willis is PO BOX 2153 DEPT 20002 Birmingham, AL 35287- 6182424600 (mailing address contact number - 8774650012).
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Provider Business Location on Map

FAQs:

What is the NPI Number for Dr. Jerrold C Willis ?


Answer: The NPI Number for Dr. Jerrold C Willis is 1467407072

Where is Dr. Jerrold C Willis located?


Answer: Dr. Jerrold C Willis is located at 1 GOOD SAMARITAN WAY RADIOLOGY DEPT Mount Vernon, IL 62864.

What is the specialty for Dr. Jerrold C Willis ?


Answer: The Specialty of Dr. Jerrold C Willis is A Radiology Physician.

Are there any online reviews for Dr. Jerrold C Willis ?


Answer: Yes! Check It Now.

Are there any other health care providers in Mount Vernon, IL?


Answer: Yes, there are given below...

Medicare Physician & Other Practitioners

Information on services and procedures provided to Original Medicare (fee-for-service) Part B (Medical Insurance) beneficiaries by Dr. Jerrold C Willis

Number of HCPCS 193
Number of Medicare Beneficiaries 2390
Number of Services 4260
Total Submitted Charge Amount 1136451.68
Total Medicare Allowed Amount 196945.15
Total Medicare Payment Amount 162042.58
Total Medicare Standardized Payment Amount 156803.75
Drug Suppress Indicator
Number of HCPCS Associated With Drug Services 0
Number of Medicare Beneficiaries With Drug Services 0
Number of Drug Services 0
Total Drug Submitted Charge Amount 0
Total Drug Medicare Allowed Amount 0
Total Drug Medicare Payment Amount 0
Total Drug Medicare Standardized Payment Amount 0
Medical Suppress Indicator
Number of HCPCS Associated With Medical Services 193
Number of Medicare Beneficiaries With Medical 2390
Number of Medical Services 4260
Total Medical Submitted Charge Amount 1136451.68
Total Medical Medicare Allowed Amount 196945.15
Total Medical Medicare Payment Amount 162042.58
Total Medical Medicare Standardized Payment Amount 156803.75
Average Age of Beneficiaries 72
Number of Beneficiaries Age Less 65 374
Number of Beneficiaries Age 65 to 74 1064
Number of Beneficiaries Age 75 to 84 708
Number of Beneficiaries Age Greater 84 244
Number of Female Beneficiaries 1460
Number of Male Beneficiaries 930
Number of Non-Hispanic White Beneficiaries 2263
Number of Black or African American Beneficiaries 75
Number of Asian Pacific Islander Beneficiaries
Number of Hispanic Beneficiaries
Number of American Indian/Alaska Native Beneficiaries
Number of Beneficiaries With Race Not Elsewhere Classified 29
Number of Beneficiaries With Medicare & Medicaid Entitlement 726
Number of Beneficiaries With Medicare Only Entitlement 1664
Percent (%) of Beneficiaries Identified With Atrial Fibrillation 0.16
Percent (%) of Beneficiaries Identified With Alzheimer's Disease or Dementia 0.15
Percent (%) of Beneficiaries Identified With Asthma 0.08
Percent (%) of Beneficiaries Identified With Cancer 0.15
Percent (%) of Beneficiaries Identified With Heart Failure 0.29
Percent (%) of Beneficiaries Identified With Chronic Kidney Disease 0.47
Percent (%) of Beneficiaries Identified With Chronic Obstructive Pulmonary Disease 0.33
Percent (%) of Beneficiaries Identified With Depression 0.3
Percent (%) of Beneficiaries Identified With Diabetes 0.4
Percent (%) of Beneficiaries Identified With Hyperlipidemia 0.71
Percent (%) of Beneficiaries Identified With Hypertension 0.75
Percent (%) of Beneficiaries Identified With Ischemic Heart Disease 0.53
Percent (%) of Beneficiaries Identified With Osteoporosis 0.16
Percent (%) of Beneficiaries Identified With Rheumatoid Arthritis / Osteoarthritis 0.52
Percent (%) of Beneficiaries Identified With Schizophrenia / Other Psychotic Disorders 0.03
Percent (%) of Beneficiaries Identified With Stroke 0.08
Average HCC Risk Score of Beneficiaries 1.7803

Medicare Part D Prescribers

Information on prescription drugs provided to Medicare beneficiaries enrolled in Part D (Prescription Drug Coverage), by physicians and other health care providers, aggregated by provider.

Provider Specialty Type Diagnostic Radiology
Source of Provider Specialty
Number of Medicare Part D Claims, Including Refills 23
Number of Standardized 30-Day Fills 43
Aggregate Cost Paid for All Claims 391.39
Number of Day's Supply for All Claims 954
Number of Medicare Beneficiaries
Number of Claims, Including Refills, for Beneficiaries Age 65+ 23
Including Refills, for Beneficiaries Age 65+ 43
Beneficiaries Age 65+ 391.39
Number of Day's Supply for All Claims for Beneficaries Age 65+ 954
Number of Medicare Beneficiaries Age 65+
Reason for Suppression of Brnd_Tot_Clms and Brnd_Tot_Drug_Cst
Total Claims of Brand-Name Drugs 0
Reason for Suppression of Gnrc_Tot_Clms and Gnrc_Tot_Drug_Cst
Total Claims of Generic Drugs, Including Refills 23
Aggregate Cost Paid for Generic Drugs 391.39
Reason for Suppression of Othr_Tot_Clms and Othr_Tot_Drug_Cst
Total Claims of Other Drugs, Including Refills 0
Aggregate Cost Paid for Other Drugs 0
Reason for Suppression of MAPD_Tot_Clmsand MAPD_Tot_Drug_Cst *
Number of Claims for Beneficiaries Covered by MAPD Plans
Aggregate Cost Paid for Claims Filled by Beneficiaries in MAPD Plans
Reason for Suppression of PDP_Tot_Clms and PDP_Tot_Drug_Cst #
Number of Claims for Beneficiaries Covered by Standalone PDP Plans
Aggregate Cost Paid for Claims Filled by
Reason for Suppression of LIS_Tot_Clms and LIS_Drug_Cst
Number of Claims for Beneficiaries Covered by Low-Income Subsidy 11
Aggregate Cost Paid for Claims Covered by Low-Income Subsidy 97.22
Reason for Suppression of NonLIS_Tot_Clms and NonLIS_Drug_Cst
Number of Claims for Beneficiaries Not Covered by Low-Income Subsidy 12
by Low-Income Subsidy 294.17
Total Claims of Opioid Drugs, Including
Aggregate Cost Paid for Opioid Drugs
Opioid Claims
Opioid_Tot_Clms divided by the Tot_Clms
Total Claims of Long-Acting Opioid Drugs
Aggregate Cost Paid for Long-Acting Opioid
Number of Day's Supply of All Long-Acting
Long-Acting Opioid Claims
Opioid_LA_Tot_Clms divided by the
Total Claims of Antibiotic Drugs, Including
Aggregate Cost Paid for Antibiotic Drugs
Antibiotic Claims
Reason for Suppression of Antpsyct_GE65_Tot_Clms and Antpsyct_GE65_Tot_Drug_Cst
Including Refills, for Beneficiaries Age 65+ 0
Aggregate Cost Paid for AntipsychoticDrugs for Beneficiaries Age 65+ 0
Reason for Suppression of Antpsyct_GE65_Tot_Benes
Number of Medicare Beneficiaries Age 65+Filling Antipsychotic Claims
Average Age of Beneficiaries 72.857142857
Number of Beneficiaries Age Less Than 65
Number of Beneficiaries Age 65 to 74
Number of Beneficiaries Age 75 to 84
Number of Female Beneficiaries
Number of Male Beneficiaries
Number of Non-Hispanic White
Number of Black or African American
Number of Asian Pacific Islander
Number of Hispanic Beneficiaries
Number of American Indian/Alaskan NativeBeneficiaries
Number of Beneficiaries with Race Not
Only Entitlement
Average Hierarchical Condition Category 3.8686733123

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