| National Provider Identifier [NPI]: | 1780603985 |
| Last Name Of The Provider | FORD |
| First Name Of The Provider | KRISTINA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 HOSPITAL CENTER COMMON |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HILTON HEAD ISLAND |
| Zip Code Of The Provider | 29926 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 10290 |
| Number Of Medicare Beneficiaries | 1651 |
| Total Submitted Charge Amount | 608672.04 |
| Total Medicare Allowed Amount | 420641.18 |
| Total Medicare Payment Amount | 293983.97 |
| Total Medicare Standardized Payment Amount | 366755.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 3195 |
| Total Drug Medicare AllowedAmount | 2300.54 |
| Total Drug Medicare PaymentAmount | 876.14 |
| Total Drug Medicare Standardized Payment Amount | 876.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 10248 |
| Number Of Medicare Beneficiaries With Medical Services | 1651 |
| Total Medical Submitted Charge Amount | 605477.04 |
| Total Medical Medicare Allowed Amount | 418340.64 |
| Total Medical Medicare Payment Amount | 293107.83 |
| Total Medical Medicare Standardized Payment Amount | 365879.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 838 |
| Number Of Beneficiaries Age 75 to 84 | 597 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 860 |
| Number Of Male Beneficiaries | 791 |
| Number Of Non Hispanic White Beneficiaries | 1606 |
| Number Of Black or African American Beneficiaries | |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7993 |