| National Provider Identifier [NPI]: | 1659338432 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | EASAW |
| 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 | 180 S STANFIELD RD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 453730106 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 897 |
| Number Of Medicare Beneficiaries | 157 |
| Total Submitted Charge Amount | 106954.94 |
| Total Medicare Allowed Amount | 42993.24 |
| Total Medicare Payment Amount | 31816.79 |
| Total Medicare Standardized Payment Amount | 32658.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 320 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 4800 |
| Total Drug Medicare AllowedAmount | 1502.92 |
| Total Drug Medicare PaymentAmount | 1147.33 |
| Total Drug Medicare Standardized Payment Amount | 1147.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 577 |
| Number Of Medicare Beneficiaries With Medical Services | 156 |
| Total Medical Submitted Charge Amount | 102154.94 |
| Total Medical Medicare Allowed Amount | 41490.32 |
| Total Medical Medicare Payment Amount | 30669.46 |
| Total Medical Medicare Standardized Payment Amount | 31511.11 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.244 |