| National Provider Identifier [NPI]: | 1861493249 |
| Last Name Of The Provider | HALLIDAY |
| First Name Of The Provider | PENELOPE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 403 E MARKET ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WASHINGTON CH |
| Zip Code Of The Provider | 431601433 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 390 |
| Number Of Medicare Beneficiaries | 81 |
| Total Submitted Charge Amount | 31837 |
| Total Medicare Allowed Amount | 25885.2 |
| Total Medicare Payment Amount | 16441.83 |
| Total Medicare Standardized Payment Amount | 17616.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1210 |
| Total Drug Medicare AllowedAmount | 559.43 |
| Total Drug Medicare PaymentAmount | 516.31 |
| Total Drug Medicare Standardized Payment Amount | 516.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 336 |
| Number Of Medicare Beneficiaries With Medical Services | 81 |
| Total Medical Submitted Charge Amount | 30627 |
| Total Medical Medicare Allowed Amount | 25325.77 |
| Total Medical Medicare Payment Amount | 15925.52 |
| Total Medical Medicare Standardized Payment Amount | 17099.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 25 |
| 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 | 62 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| 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 | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9248 |