| National Provider Identifier [NPI]: | 1336130665 |
| Last Name Of The Provider | TSOURMAS |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 W WILLIAM CANNON DR |
| Street Address 2 Of The Provider | STE 401 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787455257 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 168 |
| Number Of Medicare Beneficiaries | 38 |
| Total Submitted Charge Amount | 63964.12 |
| Total Medicare Allowed Amount | 9947.73 |
| Total Medicare Payment Amount | 7235.51 |
| Total Medicare Standardized Payment Amount | 7533.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1803.12 |
| Total Drug Medicare AllowedAmount | 628.62 |
| Total Drug Medicare PaymentAmount | 492.68 |
| Total Drug Medicare Standardized Payment Amount | 492.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 87 |
| Number Of Medicare Beneficiaries With Medical Services | 38 |
| Total Medical Submitted Charge Amount | 62161 |
| Total Medical Medicare Allowed Amount | 9319.11 |
| Total Medical Medicare Payment Amount | 6742.83 |
| Total Medical Medicare Standardized Payment Amount | 7040.99 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 27 |
| Number Of Male Beneficiaries | 11 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9394 |