National Provider Identifier [NPI]: |
1437122355 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4250 FARONIA RD |
Street Address 2 Of The Provider |
STE 4 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381166527 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
3375 |
Number Of Medicare Beneficiaries |
409 |
Total Submitted Charge Amount |
224416 |
Total Medicare Allowed Amount |
158118.4 |
Total Medicare Payment Amount |
109316.88 |
Total Medicare Standardized Payment Amount |
121722.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
472 |
Number Of Medicare Beneficiaries With Drug Services |
228 |
Total Drug Submitted ChargeAmount |
12098 |
Total Drug Medicare AllowedAmount |
5791.83 |
Total Drug Medicare PaymentAmount |
5300.52 |
Total Drug Medicare Standardized Payment Amount |
5300.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2903 |
Number Of Medicare Beneficiaries With Medical Services |
409 |
Total Medical Submitted Charge Amount |
212318 |
Total Medical Medicare Allowed Amount |
152326.57 |
Total Medical Medicare Payment Amount |
104016.36 |
Total Medical Medicare Standardized Payment Amount |
116421.59 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
228 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
257 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
390 |
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 |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
3 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.138 |