| National Provider Identifier [NPI]: | 1295760163 |
| Last Name Of The Provider | WALSH |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 SPALDING DR |
| Street Address 2 Of The Provider | 3RD FLOOR |
| City Of The Provider | NAPERVILLE |
| Zip Code Of The Provider | 605406550 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 837 |
| Number Of Medicare Beneficiaries | 363 |
| Total Submitted Charge Amount | 599036 |
| Total Medicare Allowed Amount | 66561.29 |
| Total Medicare Payment Amount | 49622.58 |
| Total Medicare Standardized Payment Amount | 49619.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 216 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 8820 |
| Total Drug Medicare AllowedAmount | 3411.83 |
| Total Drug Medicare PaymentAmount | 2670.5 |
| Total Drug Medicare Standardized Payment Amount | 2670.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 621 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 590216 |
| Total Medical Medicare Allowed Amount | 63149.46 |
| Total Medical Medicare Payment Amount | 46952.08 |
| Total Medical Medicare Standardized Payment Amount | 46948.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 124 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2025 |