National Provider Identifier [NPI]: |
1104868280 |
Last Name Of The Provider |
THOMPSON |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10494 W THUNDERBIRD BLVD |
Street Address 2 Of The Provider |
STE 102 |
City Of The Provider |
SUN CITY |
Zip Code Of The Provider |
853513058 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
5636 |
Number Of Medicare Beneficiaries |
615 |
Total Submitted Charge Amount |
1143727.8 |
Total Medicare Allowed Amount |
447287.77 |
Total Medicare Payment Amount |
340902.53 |
Total Medicare Standardized Payment Amount |
341619.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
2672 |
Number Of Medicare Beneficiaries With Drug Services |
172 |
Total Drug Submitted ChargeAmount |
39086.1 |
Total Drug Medicare AllowedAmount |
14220.29 |
Total Drug Medicare PaymentAmount |
10671.35 |
Total Drug Medicare Standardized Payment Amount |
10671.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
2964 |
Number Of Medicare Beneficiaries With Medical Services |
615 |
Total Medical Submitted Charge Amount |
1104641.7 |
Total Medical Medicare Allowed Amount |
433067.48 |
Total Medical Medicare Payment Amount |
330231.18 |
Total Medical Medicare Standardized Payment Amount |
330948.02 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
300 |
Number Of Beneficiaries Age 75 to 84 |
212 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
400 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
559 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
579 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1823 |