National Provider Identifier [NPI]: |
1497723035 |
Last Name Of The Provider |
WALSH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 N MAYFAIR RD |
Street Address 2 Of The Provider |
SUITE 545 |
City Of The Provider |
WAUWATOSA |
Zip Code Of The Provider |
532261309 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
838 |
Number Of Medicare Beneficiaries |
407 |
Total Submitted Charge Amount |
311920.6 |
Total Medicare Allowed Amount |
98214.21 |
Total Medicare Payment Amount |
71072.27 |
Total Medicare Standardized Payment Amount |
74860.7 |
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 |
58 |
Number Of Medical Services |
838 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
311920.6 |
Total Medical Medicare Allowed Amount |
98214.21 |
Total Medical Medicare Payment Amount |
71072.27 |
Total Medical Medicare Standardized Payment Amount |
74860.7 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
332 |
Number Of Non Hispanic White Beneficiaries |
368 |
Number Of Black or African American Beneficiaries |
25 |
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 |
384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1153 |