| National Provider Identifier [NPI]: | 1861431371 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 S BROOKS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHERIDAN |
| Zip Code Of The Provider | 828010000 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1247 |
| Number Of Medicare Beneficiaries | 741 |
| Total Submitted Charge Amount | 452301 |
| Total Medicare Allowed Amount | 219772.92 |
| Total Medicare Payment Amount | 154777.04 |
| Total Medicare Standardized Payment Amount | 152971.23 |
| 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 | 21 |
| Number Of Medical Services | 1247 |
| Number Of Medicare Beneficiaries With Medical Services | 741 |
| Total Medical Submitted Charge Amount | 452301 |
| Total Medical Medicare Allowed Amount | 219772.92 |
| Total Medical Medicare Payment Amount | 154777.04 |
| Total Medical Medicare Standardized Payment Amount | 152971.23 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 293 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 452 |
| Number Of Male Beneficiaries | 289 |
| Number Of Non Hispanic White Beneficiaries | 722 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9596 |