| National Provider Identifier [NPI]: | 1891777090 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1255 VISCAYA PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CAPE CORAL |
| Zip Code Of The Provider | 339903290 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 14087 |
| Number Of Medicare Beneficiaries | 799 |
| Total Submitted Charge Amount | 814964.7 |
| Total Medicare Allowed Amount | 413356.59 |
| Total Medicare Payment Amount | 315168.24 |
| Total Medicare Standardized Payment Amount | 308544.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1800 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 38416.7 |
| Total Drug Medicare AllowedAmount | 14941.19 |
| Total Drug Medicare PaymentAmount | 12989.7 |
| Total Drug Medicare Standardized Payment Amount | 12989.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 12287 |
| Number Of Medicare Beneficiaries With Medical Services | 799 |
| Total Medical Submitted Charge Amount | 776548 |
| Total Medical Medicare Allowed Amount | 398415.4 |
| Total Medical Medicare Payment Amount | 302178.54 |
| Total Medical Medicare Standardized Payment Amount | 295554.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 421 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 396 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 761 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9257 |