| National Provider Identifier [NPI]: | 1821079849 |
| Last Name Of The Provider | THIESSEN |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21214 NORTHWEST FWY |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | CYPRESS |
| Zip Code Of The Provider | 774293373 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 6024 |
| Number Of Medicare Beneficiaries | 3262 |
| Total Submitted Charge Amount | 696316.54 |
| Total Medicare Allowed Amount | 161649.76 |
| Total Medicare Payment Amount | 125804.22 |
| Total Medicare Standardized Payment Amount | 125595.58 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 384 |
| Number Of Beneficiaries Age 65 to 74 | 1478 |
| Number Of Beneficiaries Age 75 to 84 | 976 |
| Number Of Beneficiaries Age Greater 84 | 424 |
| Number Of Female Beneficiaries | 2299 |
| Number Of Male Beneficiaries | 963 |
| Number Of Non Hispanic White Beneficiaries | 2434 |
| Number Of Black or African American Beneficiaries | 389 |
| Number Of AsianPacific Islander Beneficiaries | 114 |
| Number Of Hispanic Beneficiaries | 285 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.715 |