| National Provider Identifier [NPI]: | 1497762546 |
| Last Name Of The Provider | ARNOLD |
| First Name Of The Provider | INGRID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2375 GUS THOMASSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MESQUITE |
| Zip Code Of The Provider | 751507100 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 611 |
| Number Of Medicare Beneficiaries | 127 |
| Total Submitted Charge Amount | 59438 |
| Total Medicare Allowed Amount | 40488.46 |
| Total Medicare Payment Amount | 30005.61 |
| Total Medicare Standardized Payment Amount | 31446.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1458 |
| Total Drug Medicare AllowedAmount | 654.85 |
| Total Drug Medicare PaymentAmount | 641.8 |
| Total Drug Medicare Standardized Payment Amount | 641.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 578 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 57980 |
| Total Medical Medicare Allowed Amount | 39833.61 |
| Total Medical Medicare Payment Amount | 29363.81 |
| Total Medical Medicare Standardized Payment Amount | 30804.96 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 97 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7941 |