| National Provider Identifier [NPI]: | 1306807607 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5618 ODANA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537191208 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 1998 |
| Number Of Medicare Beneficiaries | 268 |
| Total Submitted Charge Amount | 192654 |
| Total Medicare Allowed Amount | 55658.36 |
| Total Medicare Payment Amount | 42976.73 |
| Total Medicare Standardized Payment Amount | 44341.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 3416 |
| Total Drug Medicare AllowedAmount | 2348.17 |
| Total Drug Medicare PaymentAmount | 2300.44 |
| Total Drug Medicare Standardized Payment Amount | 2300.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 1933 |
| Number Of Medicare Beneficiaries With Medical Services | 268 |
| Total Medical Submitted Charge Amount | 189238 |
| Total Medical Medicare Allowed Amount | 53310.19 |
| Total Medical Medicare Payment Amount | 40676.29 |
| Total Medical Medicare Standardized Payment Amount | 42041.35 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 189 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 255 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1915 |