National Provider Identifier [NPI]: |
1528057593 |
Last Name Of The Provider |
FORD |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 HIGHWAY 66 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ASHLAND |
Zip Code Of The Provider |
975209780 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
1106 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
268576.55 |
Total Medicare Allowed Amount |
118168.08 |
Total Medicare Payment Amount |
90332.08 |
Total Medicare Standardized Payment Amount |
93102.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
1106 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
268576.55 |
Total Medical Medicare Allowed Amount |
118168.08 |
Total Medical Medicare Payment Amount |
90332.08 |
Total Medical Medicare Standardized Payment Amount |
93102.93 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
328 |
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 |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0178 |