National Provider Identifier [NPI]: |
1003877069 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E DAWSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012036 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
296 |
Number Of Services |
8265 |
Number Of Medicare Beneficiaries |
5574 |
Total Submitted Charge Amount |
1104408 |
Total Medicare Allowed Amount |
281283.72 |
Total Medicare Payment Amount |
217549.94 |
Total Medicare Standardized Payment Amount |
228598.53 |
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 |
296 |
Number Of Medical Services |
8265 |
Number Of Medicare Beneficiaries With Medical Services |
5574 |
Total Medical Submitted Charge Amount |
1104408 |
Total Medical Medicare Allowed Amount |
281283.72 |
Total Medical Medicare Payment Amount |
217549.94 |
Total Medical Medicare Standardized Payment Amount |
228598.53 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
975 |
Number Of Beneficiaries Age 65 to 74 |
2031 |
Number Of Beneficiaries Age 75 to 84 |
1725 |
Number Of Beneficiaries Age Greater 84 |
843 |
Number Of Female Beneficiaries |
3143 |
Number Of Male Beneficiaries |
2431 |
Number Of Non Hispanic White Beneficiaries |
4641 |
Number Of Black or African American Beneficiaries |
719 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
150 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
4138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1436 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7822 |