National Provider Identifier [NPI]: |
1447269618 |
Last Name Of The Provider |
WALTON |
First Name Of The Provider |
TERRI |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3311 E MURDOCK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672083054 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
2253 |
Number Of Medicare Beneficiaries |
372 |
Total Submitted Charge Amount |
226501 |
Total Medicare Allowed Amount |
155435.24 |
Total Medicare Payment Amount |
105710.06 |
Total Medicare Standardized Payment Amount |
113862.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
618 |
Number Of Medicare Beneficiaries With Drug Services |
145 |
Total Drug Submitted ChargeAmount |
20252 |
Total Drug Medicare AllowedAmount |
11696.16 |
Total Drug Medicare PaymentAmount |
10160.21 |
Total Drug Medicare Standardized Payment Amount |
10160.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1635 |
Number Of Medicare Beneficiaries With Medical Services |
372 |
Total Medical Submitted Charge Amount |
206249 |
Total Medical Medicare Allowed Amount |
143739.08 |
Total Medical Medicare Payment Amount |
95549.85 |
Total Medical Medicare Standardized Payment Amount |
103701.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
251 |
Number Of Black or African American Beneficiaries |
97 |
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 |
324 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0791 |