| National Provider Identifier [NPI]: | 1942208590 |
| Last Name Of The Provider | POTTER |
| First Name Of The Provider | IRA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 77 MILLARD ALLEN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LACKEY |
| Zip Code Of The Provider | 416430190 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 6811 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 901326 |
| Total Medicare Allowed Amount | 322793.91 |
| Total Medicare Payment Amount | 243378.13 |
| Total Medicare Standardized Payment Amount | 264116.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 530 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 29013 |
| Total Drug Medicare AllowedAmount | 2970.43 |
| Total Drug Medicare PaymentAmount | 2676.95 |
| Total Drug Medicare Standardized Payment Amount | 2676.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 6281 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 872313 |
| Total Medical Medicare Allowed Amount | 319823.48 |
| Total Medical Medicare Payment Amount | 240701.18 |
| Total Medical Medicare Standardized Payment Amount | 261439.61 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 124 |
| Number Of Male Beneficiaries | 263 |
| 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 | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9568 |