National Provider Identifier [NPI]: |
1528069119 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 E GRANT RD |
Street Address 2 Of The Provider |
ORTHOPAEDIC BLDG, 1ST FLOOR |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122805 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
3365 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
377059.5 |
Total Medicare Allowed Amount |
110377.92 |
Total Medicare Payment Amount |
81336.84 |
Total Medicare Standardized Payment Amount |
90087.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
2171 |
Number Of Medicare Beneficiaries With Drug Services |
124 |
Total Drug Submitted ChargeAmount |
67816 |
Total Drug Medicare AllowedAmount |
33954.46 |
Total Drug Medicare PaymentAmount |
26052.53 |
Total Drug Medicare Standardized Payment Amount |
26052.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
309243.5 |
Total Medical Medicare Allowed Amount |
76423.46 |
Total Medical Medicare Payment Amount |
55284.31 |
Total Medical Medicare Standardized Payment Amount |
64034.54 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
319 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
342 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9501 |