| National Provider Identifier [NPI]: | 1013213958 |
| Last Name Of The Provider | WALTER |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 72 S WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | OXFORD |
| Zip Code Of The Provider | 483716421 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 446 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 32516 |
| Total Medicare Allowed Amount | 19946.97 |
| Total Medicare Payment Amount | 13453.96 |
| Total Medicare Standardized Payment Amount | 15611.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1657 |
| Total Drug Medicare AllowedAmount | 270.76 |
| Total Drug Medicare PaymentAmount | 177.84 |
| Total Drug Medicare Standardized Payment Amount | 177.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 303 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 30859 |
| Total Medical Medicare Allowed Amount | 19676.21 |
| Total Medical Medicare Payment Amount | 13276.12 |
| Total Medical Medicare Standardized Payment Amount | 15433.58 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 57 |
| 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 | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9932 |