| National Provider Identifier [NPI]: | 1821192204 |
| Last Name Of The Provider | ROSE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 969 LAKELAND DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164699 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3703 |
| Number Of Medicare Beneficiaries | 1502 |
| Total Submitted Charge Amount | 435728 |
| Total Medicare Allowed Amount | 133043.84 |
| Total Medicare Payment Amount | 101916.25 |
| Total Medicare Standardized Payment Amount | 80639.69 |
| 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 | 3703 |
| Number Of Medicare Beneficiaries With Medical Services | 1502 |
| Total Medical Submitted Charge Amount | 435728 |
| Total Medical Medicare Allowed Amount | 133043.84 |
| Total Medical Medicare Payment Amount | 101916.25 |
| Total Medical Medicare Standardized Payment Amount | 80639.69 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 617 |
| Number Of Beneficiaries Age 75 to 84 | 423 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 880 |
| Number Of Male Beneficiaries | 622 |
| Number Of Non Hispanic White Beneficiaries | 995 |
| Number Of Black or African American Beneficiaries | 489 |
| 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 | 1060 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 442 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6894 |