| National Provider Identifier [NPI]: | 1043273386 |
| Last Name Of The Provider | WARD |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D.-PHD. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 MEDICAL DR |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 840104908 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1462 |
| Number Of Medicare Beneficiaries | 375 |
| Total Submitted Charge Amount | 132656 |
| Total Medicare Allowed Amount | 89686.75 |
| Total Medicare Payment Amount | 63340.66 |
| Total Medicare Standardized Payment Amount | 66927.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 175 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 4989 |
| Total Drug Medicare AllowedAmount | 2976.85 |
| Total Drug Medicare PaymentAmount | 2881.03 |
| Total Drug Medicare Standardized Payment Amount | 2881.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1287 |
| Number Of Medicare Beneficiaries With Medical Services | 375 |
| Total Medical Submitted Charge Amount | 127667 |
| Total Medical Medicare Allowed Amount | 86709.9 |
| Total Medical Medicare Payment Amount | 60459.63 |
| Total Medical Medicare Standardized Payment Amount | 64046.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 354 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.826 |