| National Provider Identifier [NPI]: | 1265589089 |
| Last Name Of The Provider | FORDHAM |
| First Name Of The Provider | ZACKARY |
| 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 | 4500 13TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GULFPORT |
| Zip Code Of The Provider | 39502 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1156 |
| Number Of Medicare Beneficiaries | 986 |
| Total Submitted Charge Amount | 844412 |
| Total Medicare Allowed Amount | 150437.32 |
| Total Medicare Payment Amount | 112609.22 |
| Total Medicare Standardized Payment Amount | 118167.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1156 |
| Number Of Medicare Beneficiaries With Medical Services | 986 |
| Total Medical Submitted Charge Amount | 844412 |
| Total Medical Medicare Allowed Amount | 150437.32 |
| Total Medical Medicare Payment Amount | 112609.22 |
| Total Medical Medicare Standardized Payment Amount | 118167.98 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 574 |
| Number Of Male Beneficiaries | 412 |
| Number Of Non Hispanic White Beneficiaries | 719 |
| Number Of Black or African American Beneficiaries | 242 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 552 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 434 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0524 |