| National Provider Identifier [NPI]: | 1801849435 |
| Last Name Of The Provider | FORD |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 142 CHENOWETH LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402072651 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1571 |
| Number Of Medicare Beneficiaries | 455 |
| Total Submitted Charge Amount | 120679 |
| Total Medicare Allowed Amount | 89210.24 |
| Total Medicare Payment Amount | 59999.32 |
| Total Medicare Standardized Payment Amount | 68034.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 324 |
| Total Drug Medicare AllowedAmount | 38.54 |
| Total Drug Medicare PaymentAmount | 27.21 |
| Total Drug Medicare Standardized Payment Amount | 27.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1530 |
| Number Of Medicare Beneficiaries With Medical Services | 455 |
| Total Medical Submitted Charge Amount | 120355 |
| Total Medical Medicare Allowed Amount | 89171.7 |
| Total Medical Medicare Payment Amount | 59972.11 |
| Total Medical Medicare Standardized Payment Amount | 68007.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 272 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 354 |
| Number Of Black or African American Beneficiaries | 90 |
| 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 | 349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4554 |