| National Provider Identifier [NPI]: | 1689730244 |
| Last Name Of The Provider | TOME |
| First Name Of The Provider | BASSAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1277 WELLBROOK CIR NE |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | CONYERS |
| Zip Code Of The Provider | 300123873 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2898 |
| Number Of Medicare Beneficiaries | 426 |
| Total Submitted Charge Amount | 212163 |
| Total Medicare Allowed Amount | 160589.81 |
| Total Medicare Payment Amount | 115576.61 |
| Total Medicare Standardized Payment Amount | 115636.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 278 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 10065 |
| Total Drug Medicare AllowedAmount | 5535.06 |
| Total Drug Medicare PaymentAmount | 5388.76 |
| Total Drug Medicare Standardized Payment Amount | 5388.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2620 |
| Number Of Medicare Beneficiaries With Medical Services | 426 |
| Total Medical Submitted Charge Amount | 202098 |
| Total Medical Medicare Allowed Amount | 155054.75 |
| Total Medical Medicare Payment Amount | 110187.85 |
| Total Medical Medicare Standardized Payment Amount | 110248.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 304 |
| 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 | 326 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5279 |