National Provider Identifier [NPI]: |
1619077906 |
Last Name Of The Provider |
WALTON |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
105 COLLIER RD NW |
Street Address 2 Of The Provider |
SUITE 5040 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303091710 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
707 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
85572 |
Total Medicare Allowed Amount |
36368.23 |
Total Medicare Payment Amount |
28002.94 |
Total Medicare Standardized Payment Amount |
28180.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
6702 |
Total Drug Medicare AllowedAmount |
2237.96 |
Total Drug Medicare PaymentAmount |
2192.11 |
Total Drug Medicare Standardized Payment Amount |
2192.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
637 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
78870 |
Total Medical Medicare Allowed Amount |
34130.27 |
Total Medical Medicare Payment Amount |
25810.83 |
Total Medical Medicare Standardized Payment Amount |
25988.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
123 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8087 |