| National Provider Identifier [NPI]: | 1104928282 |
| Last Name Of The Provider | THORNTON |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6499 38TH AVE N |
| Street Address 2 Of The Provider | SUITE B-2 |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337101656 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 7074 |
| Number Of Medicare Beneficiaries | 936 |
| Total Submitted Charge Amount | 420116.55 |
| Total Medicare Allowed Amount | 382509.24 |
| Total Medicare Payment Amount | 278051.77 |
| Total Medicare Standardized Payment Amount | 279516.55 |
| 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 | 49 |
| Number Of Medical Services | 7074 |
| Number Of Medicare Beneficiaries With Medical Services | 936 |
| Total Medical Submitted Charge Amount | 420116.55 |
| Total Medical Medicare Allowed Amount | 382509.24 |
| Total Medical Medicare Payment Amount | 278051.77 |
| Total Medical Medicare Standardized Payment Amount | 279516.55 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 266 |
| Number Of Beneficiaries Age 75 to 84 | 366 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 555 |
| Number Of Male Beneficiaries | 381 |
| Number Of Non Hispanic White Beneficiaries | 859 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 895 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2062 |