| National Provider Identifier [NPI]: | 1063434637 |
| Last Name Of The Provider | THOM |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 712 SOUTH CASCADE STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | FERGUS FALLS |
| Zip Code Of The Provider | 565372813 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 4876.5 |
| Number Of Medicare Beneficiaries | 1194 |
| Total Submitted Charge Amount | 1353348.77 |
| Total Medicare Allowed Amount | 503992.69 |
| Total Medicare Payment Amount | 372577.64 |
| Total Medicare Standardized Payment Amount | 380167.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 755.5 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 27825 |
| Total Drug Medicare AllowedAmount | 20078.22 |
| Total Drug Medicare PaymentAmount | 15741.33 |
| Total Drug Medicare Standardized Payment Amount | 15741.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 4121 |
| Number Of Medicare Beneficiaries With Medical Services | 1194 |
| Total Medical Submitted Charge Amount | 1325523.77 |
| Total Medical Medicare Allowed Amount | 483914.47 |
| Total Medical Medicare Payment Amount | 356836.31 |
| Total Medical Medicare Standardized Payment Amount | 364426.6 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 525 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 700 |
| Number Of Male Beneficiaries | 494 |
| Number Of Non Hispanic White Beneficiaries | 1173 |
| 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 | 1118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0031 |