| National Provider Identifier [NPI]: | 1699718429 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | P.A.C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 N NAVARRO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VICTORIA |
| Zip Code Of The Provider | 779012622 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 2154 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 94783 |
| Total Medicare Allowed Amount | 42226.17 |
| Total Medicare Payment Amount | 31558.69 |
| Total Medicare Standardized Payment Amount | 37903.4 |
| 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 | 10 |
| Number Of Medical Services | 2154 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 94783 |
| Total Medical Medicare Allowed Amount | 42226.17 |
| Total Medical Medicare Payment Amount | 31558.69 |
| Total Medical Medicare Standardized Payment Amount | 37903.4 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 195 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 50 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.933 |