| National Provider Identifier [NPI]: | 1396712840 |
| Last Name Of The Provider | BEVERIDGE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1820 PRESTON PARK BLVD |
| Street Address 2 Of The Provider | # 1450 |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750933656 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 5889 |
| Number Of Medicare Beneficiaries | 819 |
| Total Submitted Charge Amount | 1117917.46 |
| Total Medicare Allowed Amount | 417007.12 |
| Total Medicare Payment Amount | 313586.31 |
| Total Medicare Standardized Payment Amount | 336462.15 |
| 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 | 73 |
| Number Of Medical Services | 5889 |
| Number Of Medicare Beneficiaries With Medical Services | 819 |
| Total Medical Submitted Charge Amount | 1117917.46 |
| Total Medical Medicare Allowed Amount | 417007.12 |
| Total Medical Medicare Payment Amount | 313586.31 |
| Total Medical Medicare Standardized Payment Amount | 336462.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 358 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 515 |
| Number Of Non Hispanic White Beneficiaries | 748 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 751 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 56 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7222 |