| National Provider Identifier [NPI]: | 1467478974 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | CARRIE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40 OKATIE CENTER BLVD S |
| Street Address 2 Of The Provider | SUITE#210 |
| City Of The Provider | OKATIE |
| Zip Code Of The Provider | 299097507 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 11509 |
| Number Of Medicare Beneficiaries | 1939 |
| Total Submitted Charge Amount | 1192905.75 |
| Total Medicare Allowed Amount | 606676.72 |
| Total Medicare Payment Amount | 438295.58 |
| Total Medicare Standardized Payment Amount | 466969.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 10991.6 |
| Total Drug Medicare AllowedAmount | 10186.87 |
| Total Drug Medicare PaymentAmount | 7848.76 |
| Total Drug Medicare Standardized Payment Amount | 7848.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 11403 |
| Number Of Medicare Beneficiaries With Medical Services | 1939 |
| Total Medical Submitted Charge Amount | 1181914.15 |
| Total Medical Medicare Allowed Amount | 596489.85 |
| Total Medical Medicare Payment Amount | 430446.82 |
| Total Medical Medicare Standardized Payment Amount | 459120.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 1090 |
| Number Of Beneficiaries Age 75 to 84 | 619 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 1040 |
| Number Of Male Beneficiaries | 899 |
| Number Of Non Hispanic White Beneficiaries | 1857 |
| Number Of Black or African American Beneficiaries | 36 |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1899 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7894 |