National Provider Identifier [NPI]: |
1073512588 |
Last Name Of The Provider |
HALL |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12289 HANCOCK ST |
Street Address 2 Of The Provider |
STE 34 |
City Of The Provider |
CARMEL |
Zip Code Of The Provider |
460325801 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
4125 |
Number Of Medicare Beneficiaries |
555 |
Total Submitted Charge Amount |
1446357 |
Total Medicare Allowed Amount |
341839.99 |
Total Medicare Payment Amount |
254663.12 |
Total Medicare Standardized Payment Amount |
253804.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
820 |
Number Of Medicare Beneficiaries With Drug Services |
328 |
Total Drug Submitted ChargeAmount |
28082 |
Total Drug Medicare AllowedAmount |
4149.82 |
Total Drug Medicare PaymentAmount |
3163.48 |
Total Drug Medicare Standardized Payment Amount |
3163.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
3305 |
Number Of Medicare Beneficiaries With Medical Services |
555 |
Total Medical Submitted Charge Amount |
1418275 |
Total Medical Medicare Allowed Amount |
337690.17 |
Total Medical Medicare Payment Amount |
251499.64 |
Total Medical Medicare Standardized Payment Amount |
250641.2 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
166 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
227 |
Number Of Non Hispanic White Beneficiaries |
518 |
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 |
458 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0787 |