| National Provider Identifier [NPI]: | 1063746345 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | VICKEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1771 CURTIS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | IUKA |
| Zip Code Of The Provider | 388521001 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 4348 |
| Number Of Medicare Beneficiaries | 417 |
| Total Submitted Charge Amount | 194691 |
| Total Medicare Allowed Amount | 106390.29 |
| Total Medicare Payment Amount | 80173.02 |
| Total Medicare Standardized Payment Amount | 101944.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1278 |
| Number Of Medicare Beneficiaries With Drug Services | 218 |
| Total Drug Submitted ChargeAmount | 6928 |
| Total Drug Medicare AllowedAmount | 2693.83 |
| Total Drug Medicare PaymentAmount | 2328.55 |
| Total Drug Medicare Standardized Payment Amount | 2328.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 3070 |
| Number Of Medicare Beneficiaries With Medical Services | 417 |
| Total Medical Submitted Charge Amount | 187763 |
| Total Medical Medicare Allowed Amount | 103696.46 |
| Total Medical Medicare Payment Amount | 77844.47 |
| Total Medical Medicare Standardized Payment Amount | 99616.14 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 272 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 288 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9962 |