National Provider Identifier [NPI]: |
1255412466 |
Last Name Of The Provider |
HALL |
First Name Of The Provider |
PAMELA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 DELTONA BLVD |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
DELTONA |
Zip Code Of The Provider |
327257177 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1699 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
183381.84 |
Total Medicare Allowed Amount |
182654.74 |
Total Medicare Payment Amount |
130164.83 |
Total Medicare Standardized Payment Amount |
131126.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
1699 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
183381.84 |
Total Medical Medicare Allowed Amount |
182654.74 |
Total Medical Medicare Payment Amount |
130164.83 |
Total Medical Medicare Standardized Payment Amount |
131126.16 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
168 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
61 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.591 |