National Provider Identifier [NPI]: |
1548221419 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
451 DUNLAP STREET NORTH |
Street Address 2 Of The Provider |
MS32700A |
City Of The Provider |
ST PAUL |
Zip Code Of The Provider |
551042595 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
874 |
Number Of Medicare Beneficiaries |
70 |
Total Submitted Charge Amount |
72165 |
Total Medicare Allowed Amount |
26942.4 |
Total Medicare Payment Amount |
19772.94 |
Total Medicare Standardized Payment Amount |
19999.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
390 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
6253 |
Total Drug Medicare AllowedAmount |
3153.6 |
Total Drug Medicare PaymentAmount |
2408.3 |
Total Drug Medicare Standardized Payment Amount |
2408.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
484 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
65912 |
Total Medical Medicare Allowed Amount |
23788.8 |
Total Medical Medicare Payment Amount |
17364.64 |
Total Medical Medicare Standardized Payment Amount |
17591.4 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
22 |
Number Of Non Hispanic White Beneficiaries |
34 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
25 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
33 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3411 |