| National Provider Identifier [NPI]: | 1891773248 |
| Last Name Of The Provider | THURSTON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 S DAVIS AVE |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432221535 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 960 |
| Number Of Medicare Beneficiaries | 389 |
| Total Submitted Charge Amount | 101096 |
| Total Medicare Allowed Amount | 83423.45 |
| Total Medicare Payment Amount | 63823.66 |
| Total Medicare Standardized Payment Amount | 66094.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 960 |
| Number Of Medicare Beneficiaries With Medical Services | 389 |
| Total Medical Submitted Charge Amount | 101096 |
| Total Medical Medicare Allowed Amount | 83423.45 |
| Total Medical Medicare Payment Amount | 63823.66 |
| Total Medical Medicare Standardized Payment Amount | 66094.16 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| 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 | 230 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.3367 |