National Provider Identifier [NPI]: |
1306826441 |
Last Name Of The Provider |
LOWER |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
127 W WASHINGTON STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
OSCEOLA |
Zip Code Of The Provider |
502131248 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1477 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
116319 |
Total Medicare Allowed Amount |
74804.25 |
Total Medicare Payment Amount |
45538.93 |
Total Medicare Standardized Payment Amount |
55262.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1255 |
Total Drug Medicare AllowedAmount |
215.33 |
Total Drug Medicare PaymentAmount |
144.92 |
Total Drug Medicare Standardized Payment Amount |
144.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1440 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
115064 |
Total Medical Medicare Allowed Amount |
74588.92 |
Total Medical Medicare Payment Amount |
45394.01 |
Total Medical Medicare Standardized Payment Amount |
55117.92 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
151 |
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 |
263 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.7945 |