| National Provider Identifier [NPI]: | 1922002518 |
| Last Name Of The Provider | HAMM |
| First Name Of The Provider | BETHANN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 180 GREENVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARION |
| Zip Code Of The Provider | 162141645 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 774 |
| Number Of Medicare Beneficiaries | 235 |
| Total Submitted Charge Amount | 63850 |
| Total Medicare Allowed Amount | 52170.09 |
| Total Medicare Payment Amount | 37432.26 |
| Total Medicare Standardized Payment Amount | 38985.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 5090 |
| Total Drug Medicare AllowedAmount | 4336.95 |
| Total Drug Medicare PaymentAmount | 4241.14 |
| Total Drug Medicare Standardized Payment Amount | 4241.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 698 |
| Number Of Medicare Beneficiaries With Medical Services | 235 |
| Total Medical Submitted Charge Amount | 58760 |
| Total Medical Medicare Allowed Amount | 47833.14 |
| Total Medical Medicare Payment Amount | 33191.12 |
| Total Medical Medicare Standardized Payment Amount | 34744.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 65 |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.854 |