| National Provider Identifier [NPI]: | 1437153194 |
| Last Name Of The Provider | INGRAM |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2412 RING RD |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | ELIZABETHTOWN |
| Zip Code Of The Provider | 427015913 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 4192 |
| Number Of Medicare Beneficiaries | 761 |
| Total Submitted Charge Amount | 194891.81 |
| Total Medicare Allowed Amount | 154411.84 |
| Total Medicare Payment Amount | 108615.84 |
| Total Medicare Standardized Payment Amount | 118763.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1423 |
| Number Of Medicare Beneficiaries With Drug Services | 370 |
| Total Drug Submitted ChargeAmount | 26322 |
| Total Drug Medicare AllowedAmount | 8151.55 |
| Total Drug Medicare PaymentAmount | 7303.67 |
| Total Drug Medicare Standardized Payment Amount | 7303.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2769 |
| Number Of Medicare Beneficiaries With Medical Services | 760 |
| Total Medical Submitted Charge Amount | 168569.81 |
| Total Medical Medicare Allowed Amount | 146260.29 |
| Total Medical Medicare Payment Amount | 101312.17 |
| Total Medical Medicare Standardized Payment Amount | 111460.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 151 |
| Number Of Beneficiaries Age 65 to 74 | 374 |
| Number Of Beneficiaries Age 75 to 84 | 178 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 437 |
| Number Of Male Beneficiaries | 324 |
| Number Of Non Hispanic White Beneficiaries | 716 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9738 |