National Provider Identifier [NPI]: |
1215248950 |
Last Name Of The Provider |
WALKER |
First Name Of The Provider |
FOREST |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
240 CAVE RUN CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
VERSAILLES |
Zip Code Of The Provider |
403837014 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
173 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
123432 |
Total Medicare Allowed Amount |
22873.55 |
Total Medicare Payment Amount |
17794.13 |
Total Medicare Standardized Payment Amount |
18511.09 |
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 |
10 |
Number Of Medical Services |
173 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
123432 |
Total Medical Medicare Allowed Amount |
22873.55 |
Total Medical Medicare Payment Amount |
17794.13 |
Total Medical Medicare Standardized Payment Amount |
18511.09 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
|
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8619 |