| National Provider Identifier [NPI]: | 1881875771 |
| Last Name Of The Provider | HAHN |
| First Name Of The Provider | SHELBY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1423 N. JEFFERSON |
| Street Address 2 Of The Provider | #B100 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658021917 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 1243 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 103535 |
| Total Medicare Allowed Amount | 59632.9 |
| Total Medicare Payment Amount | 40577.41 |
| Total Medicare Standardized Payment Amount | 44086.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 211 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 4411 |
| Total Drug Medicare AllowedAmount | 1989.15 |
| Total Drug Medicare PaymentAmount | 1667.56 |
| Total Drug Medicare Standardized Payment Amount | 1667.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1032 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 99124 |
| Total Medical Medicare Allowed Amount | 57643.75 |
| Total Medical Medicare Payment Amount | 38909.85 |
| Total Medical Medicare Standardized Payment Amount | 42418.71 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 199 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 315 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4315 |