National Provider Identifier [NPI]: |
1922278126 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
324 DOOLITTLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WOODBURY |
Zip Code Of The Provider |
371901139 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
425 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
569728 |
Total Medicare Allowed Amount |
57069.89 |
Total Medicare Payment Amount |
44112.61 |
Total Medicare Standardized Payment Amount |
46420.25 |
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 |
31 |
Number Of Medical Services |
425 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
569728 |
Total Medical Medicare Allowed Amount |
57069.89 |
Total Medical Medicare Payment Amount |
44112.61 |
Total Medical Medicare Standardized Payment Amount |
46420.25 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
311 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7633 |