| National Provider Identifier [NPI]: | 1134195118 |
| Last Name Of The Provider | WALI |
| First Name Of The Provider | JYOTIKA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 E CHAPMAN AVE |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928313811 |
| 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 | 33 |
| Number Of Services | 1858 |
| Number Of Medicare Beneficiaries | 104 |
| Total Submitted Charge Amount | 192739 |
| Total Medicare Allowed Amount | 146661.84 |
| Total Medicare Payment Amount | 110312.84 |
| Total Medicare Standardized Payment Amount | 102887.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 485 |
| Total Drug Medicare AllowedAmount | 118.6 |
| Total Drug Medicare PaymentAmount | 109.17 |
| Total Drug Medicare Standardized Payment Amount | 109.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1813 |
| Number Of Medicare Beneficiaries With Medical Services | 104 |
| Total Medical Submitted Charge Amount | 192254 |
| Total Medical Medicare Allowed Amount | 146543.24 |
| Total Medical Medicare Payment Amount | 110203.67 |
| Total Medical Medicare Standardized Payment Amount | 102778.35 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 58 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9879 |