| National Provider Identifier [NPI]: | 1851340145 |
| Last Name Of The Provider | HALLER |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1052 GULL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490481734 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1973 |
| Number Of Medicare Beneficiaries | 1039 |
| Total Submitted Charge Amount | 630664 |
| Total Medicare Allowed Amount | 235397.48 |
| Total Medicare Payment Amount | 161040.54 |
| Total Medicare Standardized Payment Amount | 170225.8 |
| 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 | 28 |
| Number Of Medical Services | 1973 |
| Number Of Medicare Beneficiaries With Medical Services | 1039 |
| Total Medical Submitted Charge Amount | 630664 |
| Total Medical Medicare Allowed Amount | 235397.48 |
| Total Medical Medicare Payment Amount | 161040.54 |
| Total Medical Medicare Standardized Payment Amount | 170225.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 403 |
| Number Of Beneficiaries Age Greater 84 | 205 |
| Number Of Female Beneficiaries | 654 |
| Number Of Male Beneficiaries | 385 |
| Number Of Non Hispanic White Beneficiaries | 936 |
| Number Of Black or African American Beneficiaries | 68 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 953 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1528 |