| National Provider Identifier [NPI]: | 1043342868 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | JIMMIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1151 HOSPITAL WAY |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | POCATELLO |
| Zip Code Of The Provider | 832015091 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 634 |
| Number Of Medicare Beneficiaries | 169 |
| Total Submitted Charge Amount | 108525 |
| Total Medicare Allowed Amount | 83935.03 |
| Total Medicare Payment Amount | 60411.02 |
| Total Medicare Standardized Payment Amount | 69985.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 167 |
| Total Drug Medicare AllowedAmount | 48.94 |
| Total Drug Medicare PaymentAmount | 41.31 |
| Total Drug Medicare Standardized Payment Amount | 41.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 616 |
| Number Of Medicare Beneficiaries With Medical Services | 169 |
| Total Medical Submitted Charge Amount | 108358 |
| Total Medical Medicare Allowed Amount | 83886.09 |
| Total Medical Medicare Payment Amount | 60369.71 |
| Total Medical Medicare Standardized Payment Amount | 69944.02 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 72 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 43 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.7903 |