| National Provider Identifier [NPI]: | 1285670810 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | GLEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7557B DANNAHER WAY |
| Street Address 2 Of The Provider | SUITE 225 |
| City Of The Provider | POWELL |
| Zip Code Of The Provider | 378493568 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 6745 |
| Number Of Medicare Beneficiaries | 380 |
| Total Submitted Charge Amount | 398598 |
| Total Medicare Allowed Amount | 206872.28 |
| Total Medicare Payment Amount | 165402.55 |
| Total Medicare Standardized Payment Amount | 175820.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 230 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 8290 |
| Total Drug Medicare AllowedAmount | 6350.11 |
| Total Drug Medicare PaymentAmount | 5954.8 |
| Total Drug Medicare Standardized Payment Amount | 5954.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 6515 |
| Number Of Medicare Beneficiaries With Medical Services | 380 |
| Total Medical Submitted Charge Amount | 390308 |
| Total Medical Medicare Allowed Amount | 200522.17 |
| Total Medical Medicare Payment Amount | 159447.75 |
| Total Medical Medicare Standardized Payment Amount | 169865.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 156 |
| 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 | 354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9615 |