| National Provider Identifier [NPI]: | 1013994565 |
| Last Name Of The Provider | HALLEY |
| First Name Of The Provider | JOAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4700 POINT FOSDICK DR NW |
| Street Address 2 Of The Provider | #220 |
| City Of The Provider | GIG HARBOR |
| Zip Code Of The Provider | 98335 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 2218 |
| Number Of Medicare Beneficiaries | 163 |
| Total Submitted Charge Amount | 146294.5 |
| Total Medicare Allowed Amount | 81305.12 |
| Total Medicare Payment Amount | 62062.4 |
| Total Medicare Standardized Payment Amount | 63227.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 567 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 14236.5 |
| Total Drug Medicare AllowedAmount | 11341.76 |
| Total Drug Medicare PaymentAmount | 9556.85 |
| Total Drug Medicare Standardized Payment Amount | 9556.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1651 |
| Number Of Medicare Beneficiaries With Medical Services | 163 |
| Total Medical Submitted Charge Amount | 132058 |
| Total Medical Medicare Allowed Amount | 69963.36 |
| Total Medical Medicare Payment Amount | 52505.55 |
| Total Medical Medicare Standardized Payment Amount | 53671.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 35 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7176 |