| National Provider Identifier [NPI]: | 1336247899 |
| Last Name Of The Provider | HOLLOWAY |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 181 N KENTUCKY ST STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST PLAINS |
| Zip Code Of The Provider | 657752089 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 7091 |
| Number Of Medicare Beneficiaries | 1161 |
| Total Submitted Charge Amount | 889342.6 |
| Total Medicare Allowed Amount | 320109.87 |
| Total Medicare Payment Amount | 235482.02 |
| Total Medicare Standardized Payment Amount | 253525.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 727 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 194346.66 |
| Total Drug Medicare AllowedAmount | 34129.2 |
| Total Drug Medicare PaymentAmount | 26578.22 |
| Total Drug Medicare Standardized Payment Amount | 26578.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 6364 |
| Number Of Medicare Beneficiaries With Medical Services | 1161 |
| Total Medical Submitted Charge Amount | 694995.94 |
| Total Medical Medicare Allowed Amount | 285980.67 |
| Total Medical Medicare Payment Amount | 208903.8 |
| Total Medical Medicare Standardized Payment Amount | 226946.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 441 |
| Number Of Beneficiaries Age 75 to 84 | 407 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 851 |
| Number Of Non Hispanic White Beneficiaries | 1137 |
| Number Of Black or African American Beneficiaries | |
| 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 | 919 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 242 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2208 |