| National Provider Identifier [NPI]: | 1033105697 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 MEDICAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WENTZVILLE |
| Zip Code Of The Provider | 633853421 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 3275 |
| Number Of Medicare Beneficiaries | 452 |
| Total Submitted Charge Amount | 248697 |
| Total Medicare Allowed Amount | 236390.88 |
| Total Medicare Payment Amount | 168804.62 |
| Total Medicare Standardized Payment Amount | 176250.53 |
| 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 | 5 |
| Number Of Medical Services | 3275 |
| Number Of Medicare Beneficiaries With Medical Services | 452 |
| Total Medical Submitted Charge Amount | 248697 |
| Total Medical Medicare Allowed Amount | 236390.88 |
| Total Medical Medicare Payment Amount | 168804.62 |
| Total Medical Medicare Standardized Payment Amount | 176250.53 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 276 |
| Number Of Non Hispanic White Beneficiaries | 345 |
| 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 | 49 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 403 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 68 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1583 |