National Provider Identifier [NPI]: |
1285604579 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 1ST ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCHESTER |
Zip Code Of The Provider |
559050001 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
337 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
27705.37 |
Total Medicare Allowed Amount |
23896.53 |
Total Medicare Payment Amount |
14946.16 |
Total Medicare Standardized Payment Amount |
16356.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1264.62 |
Total Drug Medicare AllowedAmount |
1259.77 |
Total Drug Medicare PaymentAmount |
1219.97 |
Total Drug Medicare Standardized Payment Amount |
1219.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
289 |
Number Of Medicare Beneficiaries With Medical Services |
189 |
Total Medical Submitted Charge Amount |
26440.75 |
Total Medical Medicare Allowed Amount |
22636.76 |
Total Medical Medicare Payment Amount |
13726.19 |
Total Medical Medicare Standardized Payment Amount |
15136.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
171 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1499 |