National Provider Identifier [NPI]: |
1669407029 |
Last Name Of The Provider |
WALSH |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 2ND AVE N |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341025701 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
447 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
118084 |
Total Medicare Allowed Amount |
51279 |
Total Medicare Payment Amount |
40203.18 |
Total Medicare Standardized Payment Amount |
45046.6 |
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 |
23 |
Number Of Medical Services |
447 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
118084 |
Total Medical Medicare Allowed Amount |
51279 |
Total Medical Medicare Payment Amount |
40203.18 |
Total Medical Medicare Standardized Payment Amount |
45046.6 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
68 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8198 |