| National Provider Identifier [NPI]: | 1447281753 |
| Last Name Of The Provider | WARD |
| First Name Of The Provider | TYE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 E DOWNING ST |
| Street Address 2 Of The Provider | SUITE 214 |
| City Of The Provider | TAHLEQUAH |
| Zip Code Of The Provider | 744643234 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 134 |
| Number Of Medicare Beneficiaries | 31 |
| Total Submitted Charge Amount | 3180.42 |
| Total Medicare Allowed Amount | 1565.83 |
| Total Medicare Payment Amount | 1224.9 |
| Total Medicare Standardized Payment Amount | 1274.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1025 |
| Total Drug Medicare AllowedAmount | 88.55 |
| Total Drug Medicare PaymentAmount | 59.65 |
| Total Drug Medicare Standardized Payment Amount | 59.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 55 |
| Number Of Medicare Beneficiaries With Medical Services | 29 |
| Total Medical Submitted Charge Amount | 2155.42 |
| Total Medical Medicare Allowed Amount | 1477.28 |
| Total Medical Medicare Payment Amount | 1165.25 |
| Total Medical Medicare Standardized Payment Amount | 1215.06 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 15 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 19 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5599 |