| National Provider Identifier [NPI]: | 1528241759 |
| Last Name Of The Provider | BUSICK |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 HEMPHILL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043107 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 7144 |
| Number Of Medicare Beneficiaries | 949 |
| Total Submitted Charge Amount | 696714 |
| Total Medicare Allowed Amount | 354773.32 |
| Total Medicare Payment Amount | 254985.65 |
| Total Medicare Standardized Payment Amount | 254114.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 15728 |
| Total Drug Medicare AllowedAmount | 12675.42 |
| Total Drug Medicare PaymentAmount | 9934.63 |
| Total Drug Medicare Standardized Payment Amount | 9934.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 7076 |
| Number Of Medicare Beneficiaries With Medical Services | 949 |
| Total Medical Submitted Charge Amount | 680986 |
| Total Medical Medicare Allowed Amount | 342097.9 |
| Total Medical Medicare Payment Amount | 245051.02 |
| Total Medical Medicare Standardized Payment Amount | 244179.51 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 405 |
| Number Of Beneficiaries Age 75 to 84 | 391 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 502 |
| Number Of Non Hispanic White Beneficiaries | 924 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0271 |