| National Provider Identifier [NPI]: | 1033189568 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 NORTH WATERMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN BERNARDINO |
| Zip Code Of The Provider | 924045105 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2340 |
| Number Of Medicare Beneficiaries | 205 |
| Total Submitted Charge Amount | 88441 |
| Total Medicare Allowed Amount | 63723.69 |
| Total Medicare Payment Amount | 48245.15 |
| Total Medicare Standardized Payment Amount | 47411.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1423 |
| Total Drug Medicare AllowedAmount | 1066.1 |
| Total Drug Medicare PaymentAmount | 992.5 |
| Total Drug Medicare Standardized Payment Amount | 992.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 2237 |
| Number Of Medicare Beneficiaries With Medical Services | 205 |
| Total Medical Submitted Charge Amount | 87018 |
| Total Medical Medicare Allowed Amount | 62657.59 |
| Total Medical Medicare Payment Amount | 47252.65 |
| Total Medical Medicare Standardized Payment Amount | 46418.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 104 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2936 |