| National Provider Identifier [NPI]: | 1053311027 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | JARED |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1350 S HICKORY ST |
| Street Address 2 Of The Provider | HOLMES REGIONAL MEDICAL CENTER/RADIOLOGY |
| City Of The Provider | MELBOURNE |
| Zip Code Of The Provider | 329013224 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 5224 |
| Number Of Medicare Beneficiaries | 3334 |
| Total Submitted Charge Amount | 528458 |
| Total Medicare Allowed Amount | 176577.96 |
| Total Medicare Payment Amount | 133678.12 |
| Total Medicare Standardized Payment Amount | 135260.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 5224 |
| Number Of Medicare Beneficiaries With Medical Services | 3334 |
| Total Medical Submitted Charge Amount | 528458 |
| Total Medical Medicare Allowed Amount | 176577.96 |
| Total Medical Medicare Payment Amount | 133678.12 |
| Total Medical Medicare Standardized Payment Amount | 135260.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 528 |
| Number Of Beneficiaries Age 65 to 74 | 984 |
| Number Of Beneficiaries Age 75 to 84 | 1065 |
| Number Of Beneficiaries Age Greater 84 | 757 |
| Number Of Female Beneficiaries | 1851 |
| Number Of Male Beneficiaries | 1483 |
| Number Of Non Hispanic White Beneficiaries | 2847 |
| Number Of Black or African American Beneficiaries | 271 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 148 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2551 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 783 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.0659 |