| National Provider Identifier [NPI]: | 1033412358 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 BREWSTER BLVD |
| Street Address 2 Of The Provider | NAVAL HOSPITAL |
| City Of The Provider | CAMP LEJEUNE |
| Zip Code Of The Provider | 285472538 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1835 |
| Number Of Medicare Beneficiaries | 957 |
| Total Submitted Charge Amount | 170664.18 |
| Total Medicare Allowed Amount | 91467.45 |
| Total Medicare Payment Amount | 56583.82 |
| Total Medicare Standardized Payment Amount | 69470.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 189 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 5045 |
| Total Drug Medicare AllowedAmount | 937.18 |
| Total Drug Medicare PaymentAmount | 816.49 |
| Total Drug Medicare Standardized Payment Amount | 816.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1646 |
| Number Of Medicare Beneficiaries With Medical Services | 957 |
| Total Medical Submitted Charge Amount | 165619.18 |
| Total Medical Medicare Allowed Amount | 90530.27 |
| Total Medical Medicare Payment Amount | 55767.33 |
| Total Medical Medicare Standardized Payment Amount | 68653.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 536 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 520 |
| Number Of Male Beneficiaries | 437 |
| Number Of Non Hispanic White Beneficiaries | 897 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 922 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0087 |