| National Provider Identifier [NPI]: | 1447436894 |
| Last Name Of The Provider | WALL |
| First Name Of The Provider | JANET |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1340 CLIFTON RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303221059 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 5950 |
| Number Of Medicare Beneficiaries | 3212 |
| Total Submitted Charge Amount | 402087 |
| Total Medicare Allowed Amount | 126937.15 |
| Total Medicare Payment Amount | 106306.22 |
| Total Medicare Standardized Payment Amount | 110267.51 |
| 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 | 119 |
| Number Of Medical Services | 5950 |
| Number Of Medicare Beneficiaries With Medical Services | 3212 |
| Total Medical Submitted Charge Amount | 402087 |
| Total Medical Medicare Allowed Amount | 126937.15 |
| Total Medical Medicare Payment Amount | 106306.22 |
| Total Medical Medicare Standardized Payment Amount | 110267.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 542 |
| Number Of Beneficiaries Age 65 to 74 | 1461 |
| Number Of Beneficiaries Age 75 to 84 | 882 |
| Number Of Beneficiaries Age Greater 84 | 327 |
| Number Of Female Beneficiaries | 2473 |
| Number Of Male Beneficiaries | 739 |
| Number Of Non Hispanic White Beneficiaries | 2599 |
| Number Of Black or African American Beneficiaries | 524 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2472 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 740 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4136 |