| National Provider Identifier [NPI]: | 1760645311 |
| Last Name Of The Provider | AL-HALASEH |
| First Name Of The Provider | WAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 306 MEDICAL CENTER DR SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT PAYNE |
| Zip Code Of The Provider | 359683416 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 4831 |
| Number Of Medicare Beneficiaries | 1254 |
| Total Submitted Charge Amount | 1124117 |
| Total Medicare Allowed Amount | 428452.86 |
| Total Medicare Payment Amount | 308768.93 |
| Total Medicare Standardized Payment Amount | 338956.47 |
| 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 | 90 |
| Number Of Medical Services | 4831 |
| Number Of Medicare Beneficiaries With Medical Services | 1254 |
| Total Medical Submitted Charge Amount | 1124117 |
| Total Medical Medicare Allowed Amount | 428452.86 |
| Total Medical Medicare Payment Amount | 308768.93 |
| Total Medical Medicare Standardized Payment Amount | 338956.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 482 |
| Number Of Beneficiaries Age 75 to 84 | 415 |
| Number Of Beneficiaries Age Greater 84 | 175 |
| Number Of Female Beneficiaries | 729 |
| Number Of Male Beneficiaries | 525 |
| Number Of Non Hispanic White Beneficiaries | 1226 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 866 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 388 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3983 |