| National Provider Identifier [NPI]: | 1790720522 |
| Last Name Of The Provider | WALTON |
| First Name Of The Provider | TANIA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 9973 |
| Number Of Medicare Beneficiaries | 3292 |
| Total Submitted Charge Amount | 2078486.12 |
| Total Medicare Allowed Amount | 713787.41 |
| Total Medicare Payment Amount | 595475.51 |
| Total Medicare Standardized Payment Amount | 560500.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4590 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 8621.25 |
| Total Drug Medicare AllowedAmount | 5922.06 |
| Total Drug Medicare PaymentAmount | 4328.33 |
| Total Drug Medicare Standardized Payment Amount | 4328.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 5383 |
| Number Of Medicare Beneficiaries With Medical Services | 3292 |
| Total Medical Submitted Charge Amount | 2069864.87 |
| Total Medical Medicare Allowed Amount | 707865.35 |
| Total Medical Medicare Payment Amount | 591147.18 |
| Total Medical Medicare Standardized Payment Amount | 556172.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 393 |
| Number Of Beneficiaries Age 65 to 74 | 1663 |
| Number Of Beneficiaries Age 75 to 84 | 945 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 2732 |
| Number Of Male Beneficiaries | 560 |
| Number Of Non Hispanic White Beneficiaries | 2560 |
| Number Of Black or African American Beneficiaries | 603 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2947 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 345 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 0.9986 |