| National Provider Identifier [NPI]: | 1548263957 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | INSCRIPTION HOUSE HEALTH CENTER |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHONTO COMMUNITY POST OFFICE |
| Zip Code Of The Provider | 860547397 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 1511 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 61351.7 |
| Total Medicare Allowed Amount | 39079.91 |
| Total Medicare Payment Amount | 27380.3 |
| Total Medicare Standardized Payment Amount | 27809.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1020.84 |
| Total Drug Medicare AllowedAmount | 1020.84 |
| Total Drug Medicare PaymentAmount | 1000.46 |
| Total Drug Medicare Standardized Payment Amount | 1000.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 1470 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 60330.86 |
| Total Medical Medicare Allowed Amount | 38059.07 |
| Total Medical Medicare Payment Amount | 26379.84 |
| Total Medical Medicare Standardized Payment Amount | 26809.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 158 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 0 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 287 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 86 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3037 |