| National Provider Identifier [NPI]: | 1255366340 |
| Last Name Of The Provider | WALDER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17 WHITE HORSE PIKE |
| Street Address 2 Of The Provider | #9 |
| City Of The Provider | HADDON HEIGHTS |
| Zip Code Of The Provider | 080351299 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 3434 |
| Number Of Medicare Beneficiaries | 2145 |
| Total Submitted Charge Amount | 284465 |
| Total Medicare Allowed Amount | 76329.01 |
| Total Medicare Payment Amount | 60357.6 |
| Total Medicare Standardized Payment Amount | 58176.08 |
| 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 | 116 |
| Number Of Medical Services | 3434 |
| Number Of Medicare Beneficiaries With Medical Services | 2145 |
| Total Medical Submitted Charge Amount | 284465 |
| Total Medical Medicare Allowed Amount | 76329.01 |
| Total Medical Medicare Payment Amount | 60357.6 |
| Total Medical Medicare Standardized Payment Amount | 58176.08 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 627 |
| Number Of Beneficiaries Age 65 to 74 | 649 |
| Number Of Beneficiaries Age 75 to 84 | 501 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 804 |
| Number Of Non Hispanic White Beneficiaries | 1564 |
| Number Of Black or African American Beneficiaries | 436 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 90 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8977 |