| National Provider Identifier [NPI]: | 1144299215 |
| Last Name Of The Provider | WALSH |
| First Name Of The Provider | COLLEEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | ANP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 S WABASHA ST |
| Street Address 2 Of The Provider | MAIL STOP 31300A |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551071805 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 650 |
| Number Of Medicare Beneficiaries | 91 |
| Total Submitted Charge Amount | 59310 |
| Total Medicare Allowed Amount | 18745.35 |
| Total Medicare Payment Amount | 13589.94 |
| Total Medicare Standardized Payment Amount | 16674.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 172 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 317 |
| Total Drug Medicare AllowedAmount | 187.58 |
| Total Drug Medicare PaymentAmount | 171.72 |
| Total Drug Medicare Standardized Payment Amount | 171.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 478 |
| Number Of Medicare Beneficiaries With Medical Services | 91 |
| Total Medical Submitted Charge Amount | 58993 |
| Total Medical Medicare Allowed Amount | 18557.77 |
| Total Medical Medicare Payment Amount | 13418.22 |
| Total Medical Medicare Standardized Payment Amount | 16502.7 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0723 |