| National Provider Identifier [NPI]: | 1366629917 |
| Last Name Of The Provider | WALDING |
| First Name Of The Provider | JEFFERY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 PROFESSIONAL LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363033875 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 1691 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 508110.9 |
| Total Medicare Allowed Amount | 218182.36 |
| Total Medicare Payment Amount | 165444.71 |
| Total Medicare Standardized Payment Amount | 185393.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 3252 |
| Total Drug Medicare AllowedAmount | 3019.77 |
| Total Drug Medicare PaymentAmount | 2252.2 |
| Total Drug Medicare Standardized Payment Amount | 2252.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 1658 |
| Number Of Medicare Beneficiaries With Medical Services | 398 |
| Total Medical Submitted Charge Amount | 504858.9 |
| Total Medical Medicare Allowed Amount | 215162.59 |
| Total Medical Medicare Payment Amount | 163192.51 |
| Total Medical Medicare Standardized Payment Amount | 183141.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 171 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 219 |
| Number Of Non Hispanic White Beneficiaries | 377 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1357 |