| National Provider Identifier [NPI]: | 1922078922 |
| Last Name Of The Provider | HALL |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | CNM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 261 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SNOWFLAKE |
| Zip Code Of The Provider | 859375316 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Nurse Midwife |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 330 |
| Number Of Medicare Beneficiaries | 76 |
| Total Submitted Charge Amount | 18486 |
| Total Medicare Allowed Amount | 15493.09 |
| Total Medicare Payment Amount | 10542.04 |
| Total Medicare Standardized Payment Amount | 10664.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 974 |
| Total Drug Medicare AllowedAmount | 385.31 |
| Total Drug Medicare PaymentAmount | 338.27 |
| Total Drug Medicare Standardized Payment Amount | 338.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 230 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 17512 |
| Total Medical Medicare Allowed Amount | 15107.78 |
| Total Medical Medicare Payment Amount | 10203.77 |
| Total Medical Medicare Standardized Payment Amount | 10326.71 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 0 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6329 |