| National Provider Identifier [NPI]: | 1922007343 |
| Last Name Of The Provider | HALLBAUER |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4015 INTERSTATE 45 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONROE |
| Zip Code Of The Provider | 773044901 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3771 |
| Number Of Medicare Beneficiaries | 426 |
| Total Submitted Charge Amount | 434395.33 |
| Total Medicare Allowed Amount | 208802.77 |
| Total Medicare Payment Amount | 146935.24 |
| Total Medicare Standardized Payment Amount | 155193.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 626 |
| Number Of Medicare Beneficiaries With Drug Services | 247 |
| Total Drug Submitted ChargeAmount | 19678 |
| Total Drug Medicare AllowedAmount | 5831.74 |
| Total Drug Medicare PaymentAmount | 5355.05 |
| Total Drug Medicare Standardized Payment Amount | 5355.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 3145 |
| Number Of Medicare Beneficiaries With Medical Services | 426 |
| Total Medical Submitted Charge Amount | 414717.33 |
| Total Medical Medicare Allowed Amount | 202971.03 |
| Total Medical Medicare Payment Amount | 141580.19 |
| Total Medical Medicare Standardized Payment Amount | 149838.41 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 244 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 404 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 408 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0192 |