| National Provider Identifier [NPI]: | 1912057183 |
| Last Name Of The Provider | WALKIEWICZ |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8440 WALNUT HILL LN |
| Street Address 2 Of The Provider | STE 510 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752313833 |
| 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 | 63 |
| Number Of Services | 3429 |
| Number Of Medicare Beneficiaries | 1834 |
| Total Submitted Charge Amount | 1046612.72 |
| Total Medicare Allowed Amount | 205086.18 |
| Total Medicare Payment Amount | 156786.63 |
| Total Medicare Standardized Payment Amount | 159657 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 588 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 3814 |
| Total Drug Medicare AllowedAmount | 735.17 |
| Total Drug Medicare PaymentAmount | 547.49 |
| Total Drug Medicare Standardized Payment Amount | 547.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2841 |
| Number Of Medicare Beneficiaries With Medical Services | 1834 |
| Total Medical Submitted Charge Amount | 1042798.72 |
| Total Medical Medicare Allowed Amount | 204351.01 |
| Total Medical Medicare Payment Amount | 156239.14 |
| Total Medical Medicare Standardized Payment Amount | 159109.51 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 208 |
| Number Of Beneficiaries Age 65 to 74 | 648 |
| Number Of Beneficiaries Age 75 to 84 | 599 |
| Number Of Beneficiaries Age Greater 84 | 379 |
| Number Of Female Beneficiaries | 1087 |
| Number Of Male Beneficiaries | 747 |
| Number Of Non Hispanic White Beneficiaries | 1578 |
| Number Of Black or African American Beneficiaries | 143 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 215 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.4577 |