| National Provider Identifier [NPI]: | 1811912967 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12192 AUGUSTA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAVONIA |
| Zip Code Of The Provider | 305531209 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 6735 |
| Number Of Medicare Beneficiaries | 476 |
| Total Submitted Charge Amount | 379161 |
| Total Medicare Allowed Amount | 230367.47 |
| Total Medicare Payment Amount | 167249.33 |
| Total Medicare Standardized Payment Amount | 179391.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1453 |
| Number Of Medicare Beneficiaries With Drug Services | 234 |
| Total Drug Submitted ChargeAmount | 13876 |
| Total Drug Medicare AllowedAmount | 4782.76 |
| Total Drug Medicare PaymentAmount | 3917.1 |
| Total Drug Medicare Standardized Payment Amount | 3917.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 5282 |
| Number Of Medicare Beneficiaries With Medical Services | 476 |
| Total Medical Submitted Charge Amount | 365285 |
| Total Medical Medicare Allowed Amount | 225584.71 |
| Total Medical Medicare Payment Amount | 163332.23 |
| Total Medical Medicare Standardized Payment Amount | 175474.11 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 429 |
| Number Of Black or African American Beneficiaries | 34 |
| 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 | 311 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 165 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0358 |