| National Provider Identifier [NPI]: | 1396747846 |
| Last Name Of The Provider | FORD |
| First Name Of The Provider | HALDEN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2601 KENTUCKY AVE |
| Street Address 2 Of The Provider | SUITE 402 |
| City Of The Provider | PADUCAH |
| Zip Code Of The Provider | 420033817 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 6421 |
| Number Of Medicare Beneficiaries | 1985 |
| Total Submitted Charge Amount | 1007691.15 |
| Total Medicare Allowed Amount | 380906.54 |
| Total Medicare Payment Amount | 271186.43 |
| Total Medicare Standardized Payment Amount | 298488.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 13537.25 |
| Total Drug Medicare AllowedAmount | 5685.59 |
| Total Drug Medicare PaymentAmount | 4407.59 |
| Total Drug Medicare Standardized Payment Amount | 4407.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 6392 |
| Number Of Medicare Beneficiaries With Medical Services | 1985 |
| Total Medical Submitted Charge Amount | 994153.9 |
| Total Medical Medicare Allowed Amount | 375220.95 |
| Total Medical Medicare Payment Amount | 266778.84 |
| Total Medical Medicare Standardized Payment Amount | 294081.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 936 |
| Number Of Beneficiaries Age 75 to 84 | 693 |
| Number Of Beneficiaries Age Greater 84 | 227 |
| Number Of Female Beneficiaries | 872 |
| Number Of Male Beneficiaries | 1113 |
| Number Of Non Hispanic White Beneficiaries | 1959 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 1859 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9565 |