| National Provider Identifier [NPI]: | 1609816503 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1990 INDUSTRIAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUMA |
| Zip Code Of The Provider | 703637055 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 3042 |
| Number Of Medicare Beneficiaries | 1405 |
| Total Submitted Charge Amount | 85543 |
| Total Medicare Allowed Amount | 31246.6 |
| Total Medicare Payment Amount | 23213.36 |
| Total Medicare Standardized Payment Amount | 21290.21 |
| 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 | 15 |
| Number Of Medical Services | 3042 |
| Number Of Medicare Beneficiaries With Medical Services | 1405 |
| Total Medical Submitted Charge Amount | 85543 |
| Total Medical Medicare Allowed Amount | 31246.6 |
| Total Medical Medicare Payment Amount | 23213.36 |
| Total Medical Medicare Standardized Payment Amount | 21290.21 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 564 |
| Number Of Beneficiaries Age 65 to 74 | 582 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 718 |
| Number Of Male Beneficiaries | 687 |
| Number Of Non Hispanic White Beneficiaries | 855 |
| Number Of Black or African American Beneficiaries | 477 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 774 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.637 |