| National Provider Identifier [NPI]: | 1972502706 |
| Last Name Of The Provider | INGRAM |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1314 E 7TH ST |
| Street Address 2 Of The Provider | #101 |
| City Of The Provider | AUBURN |
| Zip Code Of The Provider | 467062535 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 883 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 121814 |
| Total Medicare Allowed Amount | 69445.19 |
| Total Medicare Payment Amount | 46575.24 |
| Total Medicare Standardized Payment Amount | 50103.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 2783 |
| Total Drug Medicare AllowedAmount | 2100.24 |
| Total Drug Medicare PaymentAmount | 1980.09 |
| Total Drug Medicare Standardized Payment Amount | 1980.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 801 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 119031 |
| Total Medical Medicare Allowed Amount | 67344.95 |
| Total Medical Medicare Payment Amount | 44595.15 |
| Total Medical Medicare Standardized Payment Amount | 48122.98 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 118 |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.039 |