| National Provider Identifier [NPI]: | 1629027784 |
| Last Name Of The Provider | HALES |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3356 KING EDWARDS CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | EUGENE |
| Zip Code Of The Provider | 974018513 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 3604 |
| Number Of Medicare Beneficiaries | 2595 |
| Total Submitted Charge Amount | 794722.28 |
| Total Medicare Allowed Amount | 173911.6 |
| Total Medicare Payment Amount | 134545.89 |
| Total Medicare Standardized Payment Amount | 131905.17 |
| Drug Suppress Indicator | * |
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| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 534 |
| Number Of Beneficiaries Age 65 to 74 | 993 |
| Number Of Beneficiaries Age 75 to 84 | 761 |
| Number Of Beneficiaries Age Greater 84 | 307 |
| Number Of Female Beneficiaries | 1501 |
| Number Of Male Beneficiaries | 1094 |
| Number Of Non Hispanic White Beneficiaries | 1776 |
| Number Of Black or African American Beneficiaries | 343 |
| Number Of AsianPacific Islander Beneficiaries | 118 |
| Number Of Hispanic Beneficiaries | 296 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1914 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 681 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 1.8187 |