National Provider Identifier [NPI]: |
1629086277 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
MARK |
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 |
2909 SE WALNUT DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOPEKA |
Zip Code Of The Provider |
666052189 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
3836 |
Number Of Medicare Beneficiaries |
518 |
Total Submitted Charge Amount |
334394.5 |
Total Medicare Allowed Amount |
238854.5 |
Total Medicare Payment Amount |
171363.89 |
Total Medicare Standardized Payment Amount |
184890.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
447 |
Number Of Medicare Beneficiaries With Drug Services |
249 |
Total Drug Submitted ChargeAmount |
18483.5 |
Total Drug Medicare AllowedAmount |
15923.11 |
Total Drug Medicare PaymentAmount |
15471.26 |
Total Drug Medicare Standardized Payment Amount |
15471.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3389 |
Number Of Medicare Beneficiaries With Medical Services |
518 |
Total Medical Submitted Charge Amount |
315911 |
Total Medical Medicare Allowed Amount |
222931.39 |
Total Medical Medicare Payment Amount |
155892.63 |
Total Medical Medicare Standardized Payment Amount |
169419.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
257 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
315 |
Number Of Black or African American Beneficiaries |
177 |
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 |
444 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0703 |