| National Provider Identifier [NPI]: | 1427091545 |
| Last Name Of The Provider | WARD |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 919 MAIN STREEET |
| Street Address 2 Of The Provider | STE. 204 |
| City Of The Provider | DYER |
| Zip Code Of The Provider | 463113717 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 3028 |
| Number Of Medicare Beneficiaries | 858 |
| Total Submitted Charge Amount | 400650.6 |
| Total Medicare Allowed Amount | 230034.84 |
| Total Medicare Payment Amount | 158994.42 |
| Total Medicare Standardized Payment Amount | 173579.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1959.6 |
| Total Drug Medicare AllowedAmount | 771.1 |
| Total Drug Medicare PaymentAmount | 596.1 |
| Total Drug Medicare Standardized Payment Amount | 596.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3004 |
| Number Of Medicare Beneficiaries With Medical Services | 858 |
| Total Medical Submitted Charge Amount | 398691 |
| Total Medical Medicare Allowed Amount | 229263.74 |
| Total Medical Medicare Payment Amount | 158398.32 |
| Total Medical Medicare Standardized Payment Amount | 172983.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 458 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 548 |
| Number Of Male Beneficiaries | 310 |
| Number Of Non Hispanic White Beneficiaries | 757 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 810 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9807 |