| National Provider Identifier [NPI]: | 1063470045 |
| Last Name Of The Provider | FORD |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 KEITH ST NW |
| Street Address 2 Of The Provider | STE C |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 373111351 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 33450 |
| Number Of Medicare Beneficiaries | 713 |
| Total Submitted Charge Amount | 1088326 |
| Total Medicare Allowed Amount | 580183.71 |
| Total Medicare Payment Amount | 442812.66 |
| Total Medicare Standardized Payment Amount | 478364.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 27635 |
| Number Of Medicare Beneficiaries With Drug Services | 200 |
| Total Drug Submitted ChargeAmount | 170148 |
| Total Drug Medicare AllowedAmount | 105307.98 |
| Total Drug Medicare PaymentAmount | 78691.65 |
| Total Drug Medicare Standardized Payment Amount | 78691.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 5815 |
| Number Of Medicare Beneficiaries With Medical Services | 713 |
| Total Medical Submitted Charge Amount | 918178 |
| Total Medical Medicare Allowed Amount | 474875.73 |
| Total Medical Medicare Payment Amount | 364121.01 |
| Total Medical Medicare Standardized Payment Amount | 399672.45 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 426 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 277 |
| Number Of Non Hispanic White Beneficiaries | 680 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.4237 |