| National Provider Identifier [NPI]: | 1407843469 |
| Last Name Of The Provider | HALSTEAD |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3800 HOLLYWOOD RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | SAINT JOSEPH |
| Zip Code Of The Provider | 490858510 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2585 |
| Number Of Medicare Beneficiaries | 866 |
| Total Submitted Charge Amount | 224890 |
| Total Medicare Allowed Amount | 156114.49 |
| Total Medicare Payment Amount | 106870.63 |
| Total Medicare Standardized Payment Amount | 116772.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 4250 |
| Total Drug Medicare AllowedAmount | 1973.71 |
| Total Drug Medicare PaymentAmount | 1531.79 |
| Total Drug Medicare Standardized Payment Amount | 1531.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 2497 |
| Number Of Medicare Beneficiaries With Medical Services | 866 |
| Total Medical Submitted Charge Amount | 220640 |
| Total Medical Medicare Allowed Amount | 154140.78 |
| Total Medical Medicare Payment Amount | 105338.84 |
| Total Medical Medicare Standardized Payment Amount | 115240.41 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 259 |
| Number Of Beneficiaries Age 75 to 84 | 320 |
| Number Of Beneficiaries Age Greater 84 | 221 |
| Number Of Female Beneficiaries | 493 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 755 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 765 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4683 |