| National Provider Identifier [NPI]: | 1538147053 |
| Last Name Of The Provider | INGOLD |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1007 HARLOW RD |
| Street Address 2 Of The Provider | STE 310 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 974777124 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1685 |
| Number Of Medicare Beneficiaries | 461 |
| Total Submitted Charge Amount | 261292 |
| Total Medicare Allowed Amount | 78270.79 |
| Total Medicare Payment Amount | 51424.1 |
| Total Medicare Standardized Payment Amount | 63422.53 |
| 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 | 43 |
| Number Of Medical Services | 1685 |
| Number Of Medicare Beneficiaries With Medical Services | 461 |
| Total Medical Submitted Charge Amount | 261292 |
| Total Medical Medicare Allowed Amount | 78270.79 |
| Total Medical Medicare Payment Amount | 51424.1 |
| Total Medical Medicare Standardized Payment Amount | 63422.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 446 |
| 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 | 431 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8986 |