| National Provider Identifier [NPI]: | 1487664983 |
| Last Name Of The Provider | STULLMAN |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1411 EAST 31ST ST |
| Street Address 2 Of The Provider | OAKCARE MEDICAL GRP |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 94602 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 2943 |
| Number Of Medicare Beneficiaries | 1475 |
| Total Submitted Charge Amount | 407767.34 |
| Total Medicare Allowed Amount | 40490.39 |
| Total Medicare Payment Amount | 30040.42 |
| Total Medicare Standardized Payment Amount | 26637.66 |
| 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 | 11 |
| Number Of Medical Services | 2943 |
| Number Of Medicare Beneficiaries With Medical Services | 1475 |
| Total Medical Submitted Charge Amount | 407767.34 |
| Total Medical Medicare Allowed Amount | 40490.39 |
| Total Medical Medicare Payment Amount | 30040.42 |
| Total Medical Medicare Standardized Payment Amount | 26637.66 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 491 |
| Number Of Beneficiaries Age 65 to 74 | 618 |
| Number Of Beneficiaries Age 75 to 84 | 240 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 669 |
| Number Of Male Beneficiaries | 806 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| Number Of Black or African American Beneficiaries | 708 |
| Number Of AsianPacific Islander Beneficiaries | 211 |
| Number Of Hispanic Beneficiaries | 201 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1148 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7433 |