| National Provider Identifier [NPI]: | 1669443768 |
| Last Name Of The Provider | FORD |
| First Name Of The Provider | MICHAEL |
| 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 | 127 CALLAHAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPALACHIA |
| Zip Code Of The Provider | 242161203 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1295 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 209428 |
| Total Medicare Allowed Amount | 96052.95 |
| Total Medicare Payment Amount | 63474.77 |
| Total Medicare Standardized Payment Amount | 66423.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 107 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 2725 |
| Total Drug Medicare AllowedAmount | 219.6 |
| Total Drug Medicare PaymentAmount | 128.02 |
| Total Drug Medicare Standardized Payment Amount | 128.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1188 |
| Number Of Medicare Beneficiaries With Medical Services | 192 |
| Total Medical Submitted Charge Amount | 206703 |
| Total Medical Medicare Allowed Amount | 95833.35 |
| Total Medical Medicare Payment Amount | 63346.75 |
| Total Medical Medicare Standardized Payment Amount | 66295.18 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 104 |
| 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 | 152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2189 |