| National Provider Identifier [NPI]: | 1609854124 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | MAUVERINE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1099 DUVAL ST |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | LEXINGTON |
| Zip Code Of The Provider | 405156490 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 265 |
| Number Of Medicare Beneficiaries | 63 |
| Total Submitted Charge Amount | 26498 |
| Total Medicare Allowed Amount | 15163.1 |
| Total Medicare Payment Amount | 10589.26 |
| Total Medicare Standardized Payment Amount | 11498.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 579 |
| Total Drug Medicare AllowedAmount | 287.26 |
| Total Drug Medicare PaymentAmount | 280.59 |
| Total Drug Medicare Standardized Payment Amount | 280.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 63 |
| Total Medical Submitted Charge Amount | 25919 |
| Total Medical Medicare Allowed Amount | 14875.84 |
| Total Medical Medicare Payment Amount | 10308.67 |
| Total Medical Medicare Standardized Payment Amount | 11217.49 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | 47 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| 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 | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0507 |