| National Provider Identifier [NPI]: | 1851517999 |
| Last Name Of The Provider | INGALLS |
| First Name Of The Provider | JERRELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LN |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 203 |
| Number Of Services | 8831 |
| Number Of Medicare Beneficiaries | 3155 |
| Total Submitted Charge Amount | 1046499.84 |
| Total Medicare Allowed Amount | 226232.15 |
| Total Medicare Payment Amount | 171412.48 |
| Total Medicare Standardized Payment Amount | 169693.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4258 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 10568.77 |
| Total Drug Medicare AllowedAmount | 1280.79 |
| Total Drug Medicare PaymentAmount | 1004.06 |
| Total Drug Medicare Standardized Payment Amount | 1004.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 4573 |
| Number Of Medicare Beneficiaries With Medical Services | 3155 |
| Total Medical Submitted Charge Amount | 1035931.07 |
| Total Medical Medicare Allowed Amount | 224951.36 |
| Total Medical Medicare Payment Amount | 170408.42 |
| Total Medical Medicare Standardized Payment Amount | 168689.72 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 751 |
| Number Of Beneficiaries Age 65 to 74 | 1234 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 361 |
| Number Of Female Beneficiaries | 1748 |
| Number Of Male Beneficiaries | 1407 |
| Number Of Non Hispanic White Beneficiaries | 2219 |
| Number Of Black or African American Beneficiaries | 421 |
| Number Of AsianPacific Islander Beneficiaries | 132 |
| Number Of Hispanic Beneficiaries | 314 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 921 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8953 |