| National Provider Identifier [NPI]: | 1710988282 |
| Last Name Of The Provider | BLAD |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12289 HANCOCK ST |
| Street Address 2 Of The Provider | SUITE 35 |
| City Of The Provider | CARMEL |
| Zip Code Of The Provider | 460325801 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 440 |
| Number Of Medicare Beneficiaries | 102 |
| Total Submitted Charge Amount | 61196 |
| Total Medicare Allowed Amount | 28740.72 |
| Total Medicare Payment Amount | 20084.97 |
| Total Medicare Standardized Payment Amount | 21271.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1014 |
| Total Drug Medicare AllowedAmount | 652.04 |
| Total Drug Medicare PaymentAmount | 632.64 |
| Total Drug Medicare Standardized Payment Amount | 632.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 412 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 60182 |
| Total Medical Medicare Allowed Amount | 28088.68 |
| Total Medical Medicare Payment Amount | 19452.33 |
| Total Medical Medicare Standardized Payment Amount | 20638.74 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 82 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9719 |