| National Provider Identifier [NPI]: | 1144205295 |
| Last Name Of The Provider | WALI |
| First Name Of The Provider | DEEPIKA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11480 BROOKSHIRE AVE |
| Street Address 2 Of The Provider | SUITE 309 |
| City Of The Provider | DOWNEY |
| Zip Code Of The Provider | 902415018 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 5601 |
| Number Of Medicare Beneficiaries | 205 |
| Total Submitted Charge Amount | 220647 |
| Total Medicare Allowed Amount | 119891.75 |
| Total Medicare Payment Amount | 92300.02 |
| Total Medicare Standardized Payment Amount | 89912.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 34 |
| Number Of Drug Services | 4966 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 162383 |
| Total Drug Medicare AllowedAmount | 82168.44 |
| Total Drug Medicare PaymentAmount | 63533.72 |
| Total Drug Medicare Standardized Payment Amount | 63533.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 635 |
| Number Of Medicare Beneficiaries With Medical Services | 205 |
| Total Medical Submitted Charge Amount | 58264 |
| Total Medical Medicare Allowed Amount | 37723.31 |
| Total Medical Medicare Payment Amount | 28766.3 |
| Total Medical Medicare Standardized Payment Amount | 26379 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 79 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1447 |