| National Provider Identifier [NPI]: | 1912996505 |
| Last Name Of The Provider | BALLARD |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2610 TENDERFOOT HILL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809063981 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1323 |
| Number Of Medicare Beneficiaries | 330 |
| Total Submitted Charge Amount | 162016 |
| Total Medicare Allowed Amount | 97386.16 |
| Total Medicare Payment Amount | 72483.77 |
| Total Medicare Standardized Payment Amount | 74162.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 8997 |
| Total Drug Medicare AllowedAmount | 6264.96 |
| Total Drug Medicare PaymentAmount | 5811.23 |
| Total Drug Medicare Standardized Payment Amount | 5811.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1090 |
| Number Of Medicare Beneficiaries With Medical Services | 330 |
| Total Medical Submitted Charge Amount | 153019 |
| Total Medical Medicare Allowed Amount | 91121.2 |
| Total Medical Medicare Payment Amount | 66672.54 |
| Total Medical Medicare Standardized Payment Amount | 68350.92 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 282 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.288 |