| National Provider Identifier [NPI]: | 1962452391 |
| Last Name Of The Provider | MAGNUSON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 988102 NEBRASKA MEDICAL CTR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681988102 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1296 |
| Number Of Medicare Beneficiaries | 667 |
| Total Submitted Charge Amount | 312350 |
| Total Medicare Allowed Amount | 119904.4 |
| Total Medicare Payment Amount | 84936.13 |
| Total Medicare Standardized Payment Amount | 90612.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1296 |
| Number Of Medicare Beneficiaries With Medical Services | 667 |
| Total Medical Submitted Charge Amount | 312350 |
| Total Medical Medicare Allowed Amount | 119904.4 |
| Total Medical Medicare Payment Amount | 84936.13 |
| Total Medical Medicare Standardized Payment Amount | 90612.23 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 419 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 623 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | 378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 34 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6018 |