National Provider Identifier [NPI]: |
1093722217 |
Last Name Of The Provider |
WALTER |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3355 RIVERBEND DR |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
974778800 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1296 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
330892 |
Total Medicare Allowed Amount |
114922.8 |
Total Medicare Payment Amount |
87878.63 |
Total Medicare Standardized Payment Amount |
89728.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
2170 |
Total Drug Medicare AllowedAmount |
1543.85 |
Total Drug Medicare PaymentAmount |
1512.92 |
Total Drug Medicare Standardized Payment Amount |
1512.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
1264 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
328722 |
Total Medical Medicare Allowed Amount |
113378.95 |
Total Medical Medicare Payment Amount |
86365.71 |
Total Medical Medicare Standardized Payment Amount |
88215.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
363 |
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 |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7699 |