| National Provider Identifier [NPI]: | 1558522946 |
| Last Name Of The Provider | MOAK-BLEST |
| First Name Of The Provider | HAYLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 281 LINCOLN ST |
| Street Address 2 Of The Provider | MED STAFF SVCS |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016052138 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 90 |
| Number Of Medicare Beneficiaries | 39 |
| Total Submitted Charge Amount | 3449 |
| Total Medicare Allowed Amount | 1525 |
| Total Medicare Payment Amount | 1433.39 |
| Total Medicare Standardized Payment Amount | 1430.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1175 |
| Total Drug Medicare AllowedAmount | 1083.5 |
| Total Drug Medicare PaymentAmount | 1061.83 |
| Total Drug Medicare Standardized Payment Amount | 1061.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 75 |
| Number Of Medicare Beneficiaries With Medical Services | 36 |
| Total Medical Submitted Charge Amount | 2274 |
| Total Medical Medicare Allowed Amount | 441.5 |
| Total Medical Medicare Payment Amount | 371.56 |
| Total Medical Medicare Standardized Payment Amount | 369.01 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 25 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8978 |