| National Provider Identifier [NPI]: | 1790871796 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH ST S |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352491900 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 11346 |
| Number Of Medicare Beneficiaries | 1708 |
| Total Submitted Charge Amount | 937626 |
| Total Medicare Allowed Amount | 163403.8 |
| Total Medicare Payment Amount | 119675.08 |
| Total Medicare Standardized Payment Amount | 133028.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 9247 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 10326 |
| Total Drug Medicare AllowedAmount | 2514.5 |
| Total Drug Medicare PaymentAmount | 1562.64 |
| Total Drug Medicare Standardized Payment Amount | 1562.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2099 |
| Number Of Medicare Beneficiaries With Medical Services | 1708 |
| Total Medical Submitted Charge Amount | 927300 |
| Total Medical Medicare Allowed Amount | 160889.3 |
| Total Medical Medicare Payment Amount | 118112.44 |
| Total Medical Medicare Standardized Payment Amount | 131465.55 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 585 |
| Number Of Beneficiaries Age 65 to 74 | 705 |
| Number Of Beneficiaries Age 75 to 84 | 344 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 888 |
| Number Of Male Beneficiaries | 820 |
| Number Of Non Hispanic White Beneficiaries | 1215 |
| Number Of Black or African American Beneficiaries | 456 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1299 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 409 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.161 |