| National Provider Identifier [NPI]: | 1487619078 |
| Last Name Of The Provider | WARD |
| First Name Of The Provider | HOLLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 10TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHALIMAR |
| Zip Code Of The Provider | 325791304 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 15699 |
| Number Of Medicare Beneficiaries | 1392 |
| Total Submitted Charge Amount | 1255803.58 |
| Total Medicare Allowed Amount | 1082801.39 |
| Total Medicare Payment Amount | 812258.06 |
| Total Medicare Standardized Payment Amount | 796155.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 464 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 7948.05 |
| Total Drug Medicare AllowedAmount | 7885.69 |
| Total Drug Medicare PaymentAmount | 5438.92 |
| Total Drug Medicare Standardized Payment Amount | 5438.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 15235 |
| Number Of Medicare Beneficiaries With Medical Services | 1392 |
| Total Medical Submitted Charge Amount | 1247855.53 |
| Total Medical Medicare Allowed Amount | 1074915.7 |
| Total Medical Medicare Payment Amount | 806819.14 |
| Total Medical Medicare Standardized Payment Amount | 790716.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 692 |
| Number Of Beneficiaries Age 75 to 84 | 512 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 761 |
| Number Of Male Beneficiaries | 631 |
| Number Of Non Hispanic White Beneficiaries | 1349 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1371 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9799 |