National Provider Identifier [NPI]: |
1306887070 |
Last Name Of The Provider |
WALTERS |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8200 WALNUT HILL LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752314426 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2033 |
Number Of Medicare Beneficiaries |
775 |
Total Submitted Charge Amount |
451945 |
Total Medicare Allowed Amount |
216911.84 |
Total Medicare Payment Amount |
169270.07 |
Total Medicare Standardized Payment Amount |
175520.53 |
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 |
19 |
Number Of Medical Services |
2033 |
Number Of Medicare Beneficiaries With Medical Services |
775 |
Total Medical Submitted Charge Amount |
451945 |
Total Medical Medicare Allowed Amount |
216911.84 |
Total Medical Medicare Payment Amount |
169270.07 |
Total Medical Medicare Standardized Payment Amount |
175520.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
252 |
Number Of Beneficiaries Age 75 to 84 |
238 |
Number Of Beneficiaries Age Greater 84 |
187 |
Number Of Female Beneficiaries |
432 |
Number Of Male Beneficiaries |
343 |
Number Of Non Hispanic White Beneficiaries |
598 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
143 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
644 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.1746 |