National Provider Identifier [NPI]: |
1629166053 |
Last Name Of The Provider |
WALMER |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
655 S DOBSON RD |
Street Address 2 Of The Provider |
A201 |
City Of The Provider |
CHANDLER |
Zip Code Of The Provider |
852245669 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
20569 |
Number Of Medicare Beneficiaries |
1022 |
Total Submitted Charge Amount |
1817886.9 |
Total Medicare Allowed Amount |
941259.74 |
Total Medicare Payment Amount |
734004.75 |
Total Medicare Standardized Payment Amount |
761335.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
433 |
Number Of Medicare Beneficiaries With Drug Services |
331 |
Total Drug Submitted ChargeAmount |
15427.63 |
Total Drug Medicare AllowedAmount |
8710.68 |
Total Drug Medicare PaymentAmount |
8106.45 |
Total Drug Medicare Standardized Payment Amount |
8106.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
20136 |
Number Of Medicare Beneficiaries With Medical Services |
1022 |
Total Medical Submitted Charge Amount |
1802459.27 |
Total Medical Medicare Allowed Amount |
932549.06 |
Total Medical Medicare Payment Amount |
725898.3 |
Total Medical Medicare Standardized Payment Amount |
753229.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
473 |
Number Of Beneficiaries Age 75 to 84 |
325 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
516 |
Number Of Male Beneficiaries |
506 |
Number Of Non Hispanic White Beneficiaries |
902 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
960 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1871 |