National Provider Identifier [NPI]: |
1750371274 |
Last Name Of The Provider |
WALDMAN |
First Name Of The Provider |
CARL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1635 N GEORGE MASON DR |
Street Address 2 Of The Provider |
NUMBER 420 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
222053601 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
56514 |
Total Medicare Allowed Amount |
34052.61 |
Total Medicare Payment Amount |
21139.1 |
Total Medicare Standardized Payment Amount |
18015.08 |
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 |
17 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
56514 |
Total Medical Medicare Allowed Amount |
34052.61 |
Total Medical Medicare Payment Amount |
21139.1 |
Total Medical Medicare Standardized Payment Amount |
18015.08 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
152 |
Number Of Black or African American Beneficiaries |
18 |
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 |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.4236 |