| National Provider Identifier [NPI]: | 1700883485 |
| Last Name Of The Provider | THOBURN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 SW ARCHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326103003 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 4458 |
| Number Of Medicare Beneficiaries | 2677 |
| Total Submitted Charge Amount | 1022759.66 |
| Total Medicare Allowed Amount | 191306.35 |
| Total Medicare Payment Amount | 142364.91 |
| Total Medicare Standardized Payment Amount | 143026.37 |
| 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 | 125 |
| Number Of Medical Services | 4458 |
| Number Of Medicare Beneficiaries With Medical Services | 2677 |
| Total Medical Submitted Charge Amount | 1022759.66 |
| Total Medical Medicare Allowed Amount | 191306.35 |
| Total Medical Medicare Payment Amount | 142364.91 |
| Total Medical Medicare Standardized Payment Amount | 143026.37 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 826 |
| Number Of Beneficiaries Age 65 to 74 | 964 |
| Number Of Beneficiaries Age 75 to 84 | 627 |
| Number Of Beneficiaries Age Greater 84 | 260 |
| Number Of Female Beneficiaries | 1340 |
| Number Of Male Beneficiaries | 1337 |
| Number Of Non Hispanic White Beneficiaries | 1998 |
| Number Of Black or African American Beneficiaries | 535 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1132 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2866 |