| National Provider Identifier [NPI]: | 1912996794 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | KENNETH |
| 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 | 2030 SUTTER PL |
| Street Address 2 Of The Provider | SUITE 1000 |
| City Of The Provider | DAVIS |
| Zip Code Of The Provider | 956166212 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 4030 |
| Number Of Medicare Beneficiaries | 573 |
| Total Submitted Charge Amount | 1392860.2 |
| Total Medicare Allowed Amount | 375993.23 |
| Total Medicare Payment Amount | 283194.37 |
| Total Medicare Standardized Payment Amount | 274337.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1352 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 96753 |
| Total Drug Medicare AllowedAmount | 41698.37 |
| Total Drug Medicare PaymentAmount | 32517.28 |
| Total Drug Medicare Standardized Payment Amount | 32517.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 2678 |
| Number Of Medicare Beneficiaries With Medical Services | 573 |
| Total Medical Submitted Charge Amount | 1296107.2 |
| Total Medical Medicare Allowed Amount | 334294.86 |
| Total Medical Medicare Payment Amount | 250677.09 |
| Total Medical Medicare Standardized Payment Amount | 241819.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 488 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1567 |