| National Provider Identifier [NPI]: | 1790770139 |
| Last Name Of The Provider | TAYLOR |
| First Name Of The Provider | IRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 S MOUNT AUBURN RD |
| Street Address 2 Of The Provider | SUITE 418 |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637034910 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 16473 |
| Number Of Medicare Beneficiaries | 960 |
| Total Submitted Charge Amount | 896595 |
| Total Medicare Allowed Amount | 537897.31 |
| Total Medicare Payment Amount | 405790.05 |
| Total Medicare Standardized Payment Amount | 439034.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 693 |
| Number Of Medicare Beneficiaries With Drug Services | 339 |
| Total Drug Submitted ChargeAmount | 16021 |
| Total Drug Medicare AllowedAmount | 10973.46 |
| Total Drug Medicare PaymentAmount | 10428.63 |
| Total Drug Medicare Standardized Payment Amount | 10428.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 15780 |
| Number Of Medicare Beneficiaries With Medical Services | 960 |
| Total Medical Submitted Charge Amount | 880574 |
| Total Medical Medicare Allowed Amount | 526923.85 |
| Total Medical Medicare Payment Amount | 395361.42 |
| Total Medical Medicare Standardized Payment Amount | 428606.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 435 |
| Number Of Beneficiaries Age 75 to 84 | 316 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 424 |
| Number Of Non Hispanic White Beneficiaries | 925 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 868 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0185 |