National Provider Identifier [NPI]: |
1912011651 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3455 MAIN ST |
Street Address 2 Of The Provider |
SUITE 7 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011071147 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
3177 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
190532.58 |
Total Medicare Allowed Amount |
83990.85 |
Total Medicare Payment Amount |
62849.36 |
Total Medicare Standardized Payment Amount |
61454.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
50.4 |
Total Drug Medicare AllowedAmount |
15.48 |
Total Drug Medicare PaymentAmount |
11.69 |
Total Drug Medicare Standardized Payment Amount |
11.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
3093 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
190482.18 |
Total Medical Medicare Allowed Amount |
83975.37 |
Total Medical Medicare Payment Amount |
62837.67 |
Total Medical Medicare Standardized Payment Amount |
61442.56 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
153 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
52 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0085 |