| National Provider Identifier [NPI]: | 1558312645 |
| Last Name Of The Provider | STEJSKAL |
| 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 | 12112 RANCHO VISTOSO 150-221 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 85755 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 9130 |
| Number Of Medicare Beneficiaries | 2784 |
| Total Submitted Charge Amount | 762096 |
| Total Medicare Allowed Amount | 245228.14 |
| Total Medicare Payment Amount | 188643 |
| Total Medicare Standardized Payment Amount | 190656.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4555 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 13665 |
| Total Drug Medicare AllowedAmount | 860.06 |
| Total Drug Medicare PaymentAmount | 674.2 |
| Total Drug Medicare Standardized Payment Amount | 674.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 4575 |
| Number Of Medicare Beneficiaries With Medical Services | 2784 |
| Total Medical Submitted Charge Amount | 748431 |
| Total Medical Medicare Allowed Amount | 244368.08 |
| Total Medical Medicare Payment Amount | 187968.8 |
| Total Medical Medicare Standardized Payment Amount | 189982.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 286 |
| Number Of Beneficiaries Age 65 to 74 | 1203 |
| Number Of Beneficiaries Age 75 to 84 | 886 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 1715 |
| Number Of Male Beneficiaries | 1069 |
| Number Of Non Hispanic White Beneficiaries | 2056 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 514 |
| Number Of American Indian Alaska Native Beneficiaries | 104 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 568 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5436 |