| National Provider Identifier [NPI]: | 1386605426 |
| Last Name Of The Provider | THACKER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6120 W BELL RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 853083781 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1506 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 114240 |
| Total Medicare Allowed Amount | 90005.41 |
| Total Medicare Payment Amount | 68418.27 |
| Total Medicare Standardized Payment Amount | 71007.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 12014 |
| Total Drug Medicare AllowedAmount | 8682.02 |
| Total Drug Medicare PaymentAmount | 8466.36 |
| Total Drug Medicare Standardized Payment Amount | 8466.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1293 |
| Number Of Medicare Beneficiaries With Medical Services | 323 |
| Total Medical Submitted Charge Amount | 102226 |
| Total Medical Medicare Allowed Amount | 81323.39 |
| Total Medical Medicare Payment Amount | 59951.91 |
| Total Medical Medicare Standardized Payment Amount | 62541.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 303 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7694 |