| National Provider Identifier [NPI]: | 1174536387 |
| Last Name Of The Provider | CARPENTER |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PHD, MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 59 EXECUTIVE PARK SOUTH NE |
| Street Address 2 Of The Provider | RADIOLOGY - 4TH FLOOR |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303292208 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 3914 |
| Number Of Medicare Beneficiaries | 2624 |
| Total Submitted Charge Amount | 238048 |
| Total Medicare Allowed Amount | 84564.91 |
| Total Medicare Payment Amount | 61831.78 |
| Total Medicare Standardized Payment Amount | 62841.59 |
| 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 | 105 |
| Number Of Medical Services | 3914 |
| Number Of Medicare Beneficiaries With Medical Services | 2624 |
| Total Medical Submitted Charge Amount | 238048 |
| Total Medical Medicare Allowed Amount | 84564.91 |
| Total Medical Medicare Payment Amount | 61831.78 |
| Total Medical Medicare Standardized Payment Amount | 62841.59 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 709 |
| Number Of Beneficiaries Age 65 to 74 | 1055 |
| Number Of Beneficiaries Age 75 to 84 | 602 |
| Number Of Beneficiaries Age Greater 84 | 258 |
| Number Of Female Beneficiaries | 1553 |
| Number Of Male Beneficiaries | 1071 |
| Number Of Non Hispanic White Beneficiaries | 1178 |
| Number Of Black or African American Beneficiaries | 1335 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1709 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 915 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7809 |