National Provider Identifier [NPI]: |
1235144676 |
Last Name Of The Provider |
WALROD |
First Name Of The Provider |
CLYDE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2701 HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
VICTORIA |
Zip Code Of The Provider |
779015748 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1047 |
Number Of Medicare Beneficiaries |
861 |
Total Submitted Charge Amount |
1612905 |
Total Medicare Allowed Amount |
162008.75 |
Total Medicare Payment Amount |
123709.89 |
Total Medicare Standardized Payment Amount |
127156.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1047 |
Number Of Medicare Beneficiaries With Medical Services |
861 |
Total Medical Submitted Charge Amount |
1612905 |
Total Medical Medicare Allowed Amount |
162008.75 |
Total Medical Medicare Payment Amount |
123709.89 |
Total Medical Medicare Standardized Payment Amount |
127156.74 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
168 |
Number Of Beneficiaries Age 65 to 74 |
235 |
Number Of Beneficiaries Age 75 to 84 |
269 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
403 |
Number Of Non Hispanic White Beneficiaries |
546 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
238 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
574 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0462 |