| National Provider Identifier [NPI]: | 1033136635 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | ALLEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1801 WINDSOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHAMPAIGN |
| Zip Code Of The Provider | 618226217 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 335 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 36918 |
| Total Medicare Allowed Amount | 15845.76 |
| Total Medicare Payment Amount | 10627.53 |
| Total Medicare Standardized Payment Amount | 13210.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 321 |
| Total Drug Medicare AllowedAmount | 67 |
| Total Drug Medicare PaymentAmount | 52.54 |
| Total Drug Medicare Standardized Payment Amount | 52.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 313 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 36597 |
| Total Medical Medicare Allowed Amount | 15778.76 |
| Total Medical Medicare Payment Amount | 10574.99 |
| Total Medical Medicare Standardized Payment Amount | 13158.36 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 147 |
| Number Of Male Beneficiaries | 67 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| Number Of Black or African American Beneficiaries | |
| 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 | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0101 |