National Provider Identifier [NPI]: |
1366403313 |
Last Name Of The Provider |
WALSH |
First Name Of The Provider |
KEVIN |
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 |
100 SPALDING DR |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
NAPERVILLE |
Zip Code Of The Provider |
605406550 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
248 |
Number Of Services |
9244 |
Number Of Medicare Beneficiaries |
1211 |
Total Submitted Charge Amount |
2767533 |
Total Medicare Allowed Amount |
820919.29 |
Total Medicare Payment Amount |
622893.05 |
Total Medicare Standardized Payment Amount |
576713.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3809 |
Number Of Medicare Beneficiaries With Drug Services |
436 |
Total Drug Submitted ChargeAmount |
241035 |
Total Drug Medicare AllowedAmount |
105755.79 |
Total Drug Medicare PaymentAmount |
82567.87 |
Total Drug Medicare Standardized Payment Amount |
82567.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
243 |
Number Of Medical Services |
5435 |
Number Of Medicare Beneficiaries With Medical Services |
1211 |
Total Medical Submitted Charge Amount |
2526498 |
Total Medical Medicare Allowed Amount |
715163.5 |
Total Medical Medicare Payment Amount |
540325.18 |
Total Medical Medicare Standardized Payment Amount |
494145.92 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
538 |
Number Of Beneficiaries Age 75 to 84 |
399 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
758 |
Number Of Male Beneficiaries |
453 |
Number Of Non Hispanic White Beneficiaries |
1050 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
52 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1082 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2516 |