| National Provider Identifier [NPI]: | 1033191408 |
| Last Name Of The Provider | LONG |
| First Name Of The Provider | CURTIS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 E BIRCH ST |
| Street Address 2 Of The Provider | SUITE 11 |
| City Of The Provider | WALLA WALLA |
| Zip Code Of The Provider | 993623054 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5932 |
| Number Of Medicare Beneficiaries | 767 |
| Total Submitted Charge Amount | 333499.61 |
| Total Medicare Allowed Amount | 308877.1 |
| Total Medicare Payment Amount | 214284.3 |
| Total Medicare Standardized Payment Amount | 214811.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 160 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1600 |
| Total Drug Medicare AllowedAmount | 284.45 |
| Total Drug Medicare PaymentAmount | 194.88 |
| Total Drug Medicare Standardized Payment Amount | 194.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 5772 |
| Number Of Medicare Beneficiaries With Medical Services | 767 |
| Total Medical Submitted Charge Amount | 331899.61 |
| Total Medical Medicare Allowed Amount | 308592.65 |
| Total Medical Medicare Payment Amount | 214089.42 |
| Total Medical Medicare Standardized Payment Amount | 214617.08 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 283 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 312 |
| Number Of Non Hispanic White Beneficiaries | 714 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5648 |