| National Provider Identifier [NPI]: | 1932101789 |
| Last Name Of The Provider | WALLS |
| First Name Of The Provider | ULYSSES |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 460 LONG RAPIDS PLZ |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALPENA |
| Zip Code Of The Provider | 497071442 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6229 |
| Number Of Medicare Beneficiaries | 1424 |
| Total Submitted Charge Amount | 879298.25 |
| Total Medicare Allowed Amount | 486726.02 |
| Total Medicare Payment Amount | 359149.15 |
| Total Medicare Standardized Payment Amount | 375370.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 537 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 40205 |
| Total Drug Medicare AllowedAmount | 28404.83 |
| Total Drug Medicare PaymentAmount | 21861.86 |
| Total Drug Medicare Standardized Payment Amount | 21861.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 5692 |
| Number Of Medicare Beneficiaries With Medical Services | 1424 |
| Total Medical Submitted Charge Amount | 839093.25 |
| Total Medical Medicare Allowed Amount | 458321.19 |
| Total Medical Medicare Payment Amount | 337287.29 |
| Total Medical Medicare Standardized Payment Amount | 353508.28 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 442 |
| Number Of Beneficiaries Age 75 to 84 | 484 |
| Number Of Beneficiaries Age Greater 84 | 288 |
| Number Of Female Beneficiaries | 704 |
| Number Of Male Beneficiaries | 720 |
| Number Of Non Hispanic White Beneficiaries | 1406 |
| 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 | 1131 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 293 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6288 |