| National Provider Identifier [NPI]: | 1124158076 |
| Last Name Of The Provider | WALKER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | HT |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5133 SAINT CHARLES RD |
| Street Address 2 Of The Provider | UNIT F |
| City Of The Provider | BELLWOOD |
| Zip Code Of The Provider | 601041054 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Slide Preparation Facility |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 3 |
| Number Of Services | 2960 |
| Number Of Medicare Beneficiaries | 1539 |
| Total Submitted Charge Amount | 101778.22 |
| Total Medicare Allowed Amount | 101249.19 |
| Total Medicare Payment Amount | 78856.83 |
| Total Medicare Standardized Payment Amount | 52852.57 |
| 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 | 3 |
| Number Of Medical Services | 2960 |
| Number Of Medicare Beneficiaries With Medical Services | 1539 |
| Total Medical Submitted Charge Amount | 101778.22 |
| Total Medical Medicare Allowed Amount | 101249.19 |
| Total Medical Medicare Payment Amount | 78856.83 |
| Total Medical Medicare Standardized Payment Amount | 52852.57 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 561 |
| Number Of Beneficiaries Age 75 to 84 | 588 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 687 |
| Number Of Male Beneficiaries | 852 |
| Number Of Non Hispanic White Beneficiaries | 1496 |
| Number Of Black or African American Beneficiaries | |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9931 |