| National Provider Identifier [NPI]: | 1316246580 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | KERI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 CONLEY LAKE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEER LODGE |
| Zip Code Of The Provider | 597228709 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 2361 |
| Number Of Medicare Beneficiaries | 501 |
| Total Submitted Charge Amount | 187013 |
| Total Medicare Allowed Amount | 74899.78 |
| Total Medicare Payment Amount | 55388.33 |
| Total Medicare Standardized Payment Amount | 65871.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 2063 |
| Total Drug Medicare AllowedAmount | 1699.36 |
| Total Drug Medicare PaymentAmount | 1641.94 |
| Total Drug Medicare Standardized Payment Amount | 1641.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 2268 |
| Number Of Medicare Beneficiaries With Medical Services | 501 |
| Total Medical Submitted Charge Amount | 184950 |
| Total Medical Medicare Allowed Amount | 73200.42 |
| Total Medical Medicare Payment Amount | 53746.39 |
| Total Medical Medicare Standardized Payment Amount | 64229.54 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 159 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 231 |
| Number Of Non Hispanic White Beneficiaries | 488 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0512 |