| National Provider Identifier [NPI]: | 1245230655 |
| Last Name Of The Provider | WALTHER |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 628 N ED CAREY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARLINGEN |
| Zip Code Of The Provider | 785507912 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 6164 |
| Number Of Medicare Beneficiaries | 1441 |
| Total Submitted Charge Amount | 718909 |
| Total Medicare Allowed Amount | 472543.58 |
| Total Medicare Payment Amount | 343586.98 |
| Total Medicare Standardized Payment Amount | 357632.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 312 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 3550 |
| Total Drug Medicare AllowedAmount | 1005.32 |
| Total Drug Medicare PaymentAmount | 713.94 |
| Total Drug Medicare Standardized Payment Amount | 713.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 5852 |
| Number Of Medicare Beneficiaries With Medical Services | 1439 |
| Total Medical Submitted Charge Amount | 715359 |
| Total Medical Medicare Allowed Amount | 471538.26 |
| Total Medical Medicare Payment Amount | 342873.04 |
| Total Medical Medicare Standardized Payment Amount | 356918.45 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 613 |
| Number Of Beneficiaries Age 75 to 84 | 543 |
| Number Of Beneficiaries Age Greater 84 | 225 |
| Number Of Female Beneficiaries | 716 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 1158 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 272 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1272 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.072 |