National Provider Identifier [NPI]: |
1952318461 |
Last Name Of The Provider |
WALLMAN |
First Name Of The Provider |
BARRY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29525 CANWOOD ST |
Street Address 2 Of The Provider |
#305 |
City Of The Provider |
AGOURA HILLS |
Zip Code Of The Provider |
913014233 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1159 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
68036.5 |
Total Medicare Allowed Amount |
61113.22 |
Total Medicare Payment Amount |
44119.09 |
Total Medicare Standardized Payment Amount |
41335.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
135 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
3529.5 |
Total Drug Medicare AllowedAmount |
2264.25 |
Total Drug Medicare PaymentAmount |
2210.34 |
Total Drug Medicare Standardized Payment Amount |
2210.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
1024 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
64507 |
Total Medical Medicare Allowed Amount |
58848.97 |
Total Medical Medicare Payment Amount |
41908.75 |
Total Medical Medicare Standardized Payment Amount |
39125.06 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
179 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8366 |