National Provider Identifier [NPI]: |
1154323277 |
Last Name Of The Provider |
WALLS |
First Name Of The Provider |
JOSEPH |
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 |
973 MICA DR |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
CARSON CITY |
Zip Code Of The Provider |
897057255 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
882 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
207458 |
Total Medicare Allowed Amount |
70737.63 |
Total Medicare Payment Amount |
52973.58 |
Total Medicare Standardized Payment Amount |
52458.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
3609 |
Total Drug Medicare AllowedAmount |
1772.55 |
Total Drug Medicare PaymentAmount |
1321.38 |
Total Drug Medicare Standardized Payment Amount |
1321.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
77 |
Number Of Medical Services |
738 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
203849 |
Total Medical Medicare Allowed Amount |
68965.08 |
Total Medical Medicare Payment Amount |
51652.2 |
Total Medical Medicare Standardized Payment Amount |
51137.33 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3129 |