| National Provider Identifier [NPI]: | 1013060904 |
| Last Name Of The Provider | WALDEN |
| First Name Of The Provider | JANICA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 462 DEERFIELD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAXLEY |
| Zip Code Of The Provider | 315137751 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 5707 |
| Number Of Medicare Beneficiaries | 3709 |
| Total Submitted Charge Amount | 1266993 |
| Total Medicare Allowed Amount | 218882.53 |
| Total Medicare Payment Amount | 174489.94 |
| Total Medicare Standardized Payment Amount | 182448.45 |
| 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 | 173 |
| Number Of Medical Services | 5707 |
| Number Of Medicare Beneficiaries With Medical Services | 3709 |
| Total Medical Submitted Charge Amount | 1266993 |
| Total Medical Medicare Allowed Amount | 218882.53 |
| Total Medical Medicare Payment Amount | 174489.94 |
| Total Medical Medicare Standardized Payment Amount | 182448.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 861 |
| Number Of Beneficiaries Age 65 to 74 | 1427 |
| Number Of Beneficiaries Age 75 to 84 | 1022 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 2511 |
| Number Of Male Beneficiaries | 1198 |
| Number Of Non Hispanic White Beneficiaries | 2967 |
| Number Of Black or African American Beneficiaries | 685 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1523 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4408 |