National Provider Identifier [NPI]: |
1609832799 |
Last Name Of The Provider |
WALTERS |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7979 W VIRGINIA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752373798 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
8200 |
Number Of Medicare Beneficiaries |
771 |
Total Submitted Charge Amount |
599961.84 |
Total Medicare Allowed Amount |
366817.95 |
Total Medicare Payment Amount |
260822.57 |
Total Medicare Standardized Payment Amount |
260325.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
22 |
Number Of Drug Services |
2939 |
Number Of Medicare Beneficiaries With Drug Services |
477 |
Total Drug Submitted ChargeAmount |
40041.47 |
Total Drug Medicare AllowedAmount |
17251.8 |
Total Drug Medicare PaymentAmount |
16348.36 |
Total Drug Medicare Standardized Payment Amount |
16348.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
5261 |
Number Of Medicare Beneficiaries With Medical Services |
771 |
Total Medical Submitted Charge Amount |
559920.37 |
Total Medical Medicare Allowed Amount |
349566.15 |
Total Medical Medicare Payment Amount |
244474.21 |
Total Medical Medicare Standardized Payment Amount |
243977.28 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
340 |
Number Of Beneficiaries Age 75 to 84 |
244 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
469 |
Number Of Male Beneficiaries |
302 |
Number Of Non Hispanic White Beneficiaries |
552 |
Number Of Black or African American Beneficiaries |
172 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
689 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0595 |