Medicare Facts for Matthew A. Wallen


National Provider Identifier [NPI]: 1962442921
Last Name Of The Provider WALLEN
First Name Of The Provider MATTHEW
Middle Initial Of The Provider C
Credentials Of The Provider MD
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 401 NORTH LIVE OAK DRIVE
Street Address 2 Of The Provider
City Of The Provider MONCKS CORNER
Zip Code Of The Provider 29461
State Code Of The Provider SC
Country Code Of The Provider US
Provider Type Of The Provider Emergency Medicine
Medicare Participation Indicator Y
Number Of HCPCS 18
Number Of Services 1422
Number Of Medicare Beneficiaries 858
Total Submitted Charge Amount 601913
Total Medicare Allowed Amount 153087.24
Total Medicare Payment Amount 118108.84
Total Medicare Standardized Payment Amount 123246.35
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 0
Number Of Drug Services 0
Number Of Medicare Beneficiaries With Drug Services 0
Total Drug Submitted ChargeAmount 0
Total Drug Medicare AllowedAmount 0
Total Drug Medicare PaymentAmount 0
Total Drug Medicare Standardized Payment Amount 0
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 18
Number Of Medical Services 1422
Number Of Medicare Beneficiaries With Medical Services 858
Total Medical Submitted Charge Amount 601913
Total Medical Medicare Allowed Amount 153087.24
Total Medical Medicare Payment Amount 118108.84
Total Medical Medicare Standardized Payment Amount 123246.35
Average Age Of Beneficiaries 70
Number Of Beneficiaries Age Less65 240
Number Of Beneficiaries Age 65 to 74 266
Number Of Beneficiaries Age 75 to 84 212
Number Of Beneficiaries Age Greater 84 140
Number Of Female Beneficiaries 507
Number Of Male Beneficiaries 351
Number Of Non Hispanic White Beneficiaries 600
Number Of Black or African American Beneficiaries 233
Number Of AsianPacific Islander Beneficiaries
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 591
Number Of Beneficiaries With Medicare Medicaid Entitlement 267
Percent Of With Atrial Fibrillation 17
Percent Of With Alzheimers Disease or Dementia 24
Percent Of With Asthma 13
Percent Of With Cancer 12
Percent Of With Heart Failure 37
Percent Of With Chronic Kidney Disease 44
Percent Of With Chronic Obstructive Pulmonary Disease 33
Percent Of With Depression 40
Percent Of With Diabetes 44
Percent Of With Hyperlipidemia 65
Percent Of With Hypertension 75
Percent Of With Ischemic Heart Disease 46
Percent Of With Osteoporosis 8
Percent Of With Rheumatoid Arthritis Osteoarthritis 46
Percent Of With Schizophrenia Other PsychoticDisorders 9
Percent Of With Stroke 14
Average HCC Risk Score Of Beneficiaries 2.1238

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