| National Provider Identifier [NPI]: | 1619930203 |
| Last Name Of The Provider | WALKER |
| First Name Of The Provider | SIDNEY |
| 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 | 5775 WAYZATA BLVD. |
| Street Address 2 Of The Provider | SUITE 190 |
| City Of The Provider | SAINT LOUIS PARK |
| Zip Code Of The Provider | 554162627 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 10937 |
| Number Of Medicare Beneficiaries | 784 |
| Total Submitted Charge Amount | 750109.42 |
| Total Medicare Allowed Amount | 136891.61 |
| Total Medicare Payment Amount | 102441.48 |
| Total Medicare Standardized Payment Amount | 104134.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 9882 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 24977 |
| Total Drug Medicare AllowedAmount | 3593.36 |
| Total Drug Medicare PaymentAmount | 2767.7 |
| Total Drug Medicare Standardized Payment Amount | 2767.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 1055 |
| Number Of Medicare Beneficiaries With Medical Services | 784 |
| Total Medical Submitted Charge Amount | 725132.42 |
| Total Medical Medicare Allowed Amount | 133298.25 |
| Total Medical Medicare Payment Amount | 99673.78 |
| Total Medical Medicare Standardized Payment Amount | 101367.1 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 291 |
| Number Of Beneficiaries Age 75 to 84 | 214 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 380 |
| Number Of Male Beneficiaries | 404 |
| Number Of Non Hispanic White Beneficiaries | 717 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2123 |