| National Provider Identifier [NPI]: | 1457432833 |
| Last Name Of The Provider | THORN |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3305 ROUTE 43 |
| Street Address 2 Of The Provider | |
| City Of The Provider | AVERILL PARK |
| Zip Code Of The Provider | 12018 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 4640 |
| Number Of Medicare Beneficiaries | 378 |
| Total Submitted Charge Amount | 268492 |
| Total Medicare Allowed Amount | 149160.47 |
| Total Medicare Payment Amount | 111739.5 |
| Total Medicare Standardized Payment Amount | 116114.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 308 |
| Number Of Medicare Beneficiaries With Drug Services | 192 |
| Total Drug Submitted ChargeAmount | 9858 |
| Total Drug Medicare AllowedAmount | 6274.56 |
| Total Drug Medicare PaymentAmount | 6127.36 |
| Total Drug Medicare Standardized Payment Amount | 6127.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 4332 |
| Number Of Medicare Beneficiaries With Medical Services | 378 |
| Total Medical Submitted Charge Amount | 258634 |
| Total Medical Medicare Allowed Amount | 142885.91 |
| Total Medical Medicare Payment Amount | 105612.14 |
| Total Medical Medicare Standardized Payment Amount | 109986.75 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 307 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1381 |