| National Provider Identifier [NPI]: | 1063453116 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 S GREEN RD |
| Street Address 2 Of The Provider | SUITE 260 |
| City Of The Provider | SOUTH EUCLID |
| Zip Code Of The Provider | 441214128 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1947 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 158462 |
| Total Medicare Allowed Amount | 107299.94 |
| Total Medicare Payment Amount | 82130.44 |
| Total Medicare Standardized Payment Amount | 85655.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 114 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 12112 |
| Total Drug Medicare AllowedAmount | 8181.81 |
| Total Drug Medicare PaymentAmount | 7870.87 |
| Total Drug Medicare Standardized Payment Amount | 7870.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1833 |
| Number Of Medicare Beneficiaries With Medical Services | 297 |
| Total Medical Submitted Charge Amount | 146350 |
| Total Medical Medicare Allowed Amount | 99118.13 |
| Total Medical Medicare Payment Amount | 74259.57 |
| Total Medical Medicare Standardized Payment Amount | 77784.21 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9721 |