National Provider Identifier [NPI]: |
1144290032 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
322 HOSPITAL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
38305 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
115 |
Number Of Services |
82447 |
Number Of Medicare Beneficiaries |
1096 |
Total Submitted Charge Amount |
3197005.81 |
Total Medicare Allowed Amount |
1191517.54 |
Total Medicare Payment Amount |
914768.05 |
Total Medicare Standardized Payment Amount |
930822.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
59 |
Number Of Drug Services |
72914 |
Number Of Medicare Beneficiaries With Drug Services |
280 |
Total Drug Submitted ChargeAmount |
2158689.06 |
Total Drug Medicare AllowedAmount |
774906.78 |
Total Drug Medicare PaymentAmount |
596719.14 |
Total Drug Medicare Standardized Payment Amount |
596719.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
9533 |
Number Of Medicare Beneficiaries With Medical Services |
1096 |
Total Medical Submitted Charge Amount |
1038316.75 |
Total Medical Medicare Allowed Amount |
416610.76 |
Total Medical Medicare Payment Amount |
318048.91 |
Total Medical Medicare Standardized Payment Amount |
334103.22 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
187 |
Number Of Beneficiaries Age 65 to 74 |
496 |
Number Of Beneficiaries Age 75 to 84 |
323 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
647 |
Number Of Male Beneficiaries |
449 |
Number Of Non Hispanic White Beneficiaries |
893 |
Number Of Black or African American Beneficiaries |
186 |
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 |
796 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
300 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
49 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.9766 |