| National Provider Identifier [NPI]: | 1487689329 |
| Last Name Of The Provider | WALDMAN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4644 LINCOLN BLVD STE 540 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARINA DEL REY |
| Zip Code Of The Provider | 902926391 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1121 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 609741 |
| Total Medicare Allowed Amount | 206224.63 |
| Total Medicare Payment Amount | 156370.6 |
| Total Medicare Standardized Payment Amount | 145488.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1740 |
| Total Drug Medicare AllowedAmount | 669.28 |
| Total Drug Medicare PaymentAmount | 653.94 |
| Total Drug Medicare Standardized Payment Amount | 653.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1091 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 608001 |
| Total Medical Medicare Allowed Amount | 205555.35 |
| Total Medical Medicare Payment Amount | 155716.66 |
| Total Medical Medicare Standardized Payment Amount | 144835.05 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 86 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 68 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 3.7243 |