| National Provider Identifier [NPI]: | 1962512293 |
| Last Name Of The Provider | WALASZEK |
| First Name Of The Provider | DALE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 265 N BINKLEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOLDOTNA |
| Zip Code Of The Provider | 996697523 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 551 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 63040 |
| Total Medicare Allowed Amount | 31896.94 |
| Total Medicare Payment Amount | 22100.77 |
| Total Medicare Standardized Payment Amount | 22822.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 669 |
| Total Drug Medicare AllowedAmount | 220.52 |
| Total Drug Medicare PaymentAmount | 203.18 |
| Total Drug Medicare Standardized Payment Amount | 203.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 484 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 62371 |
| Total Medical Medicare Allowed Amount | 31676.42 |
| Total Medical Medicare Payment Amount | 21897.59 |
| Total Medical Medicare Standardized Payment Amount | 22619.56 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0037 |