National Provider Identifier [NPI]: |
1982701652 |
Last Name Of The Provider |
THOME |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3820 HIGHWAY 365 |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PORT ARTHUR |
Zip Code Of The Provider |
776427543 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
5084 |
Number Of Medicare Beneficiaries |
801 |
Total Submitted Charge Amount |
788170 |
Total Medicare Allowed Amount |
357676.47 |
Total Medicare Payment Amount |
265734.23 |
Total Medicare Standardized Payment Amount |
281682.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
701 |
Number Of Medicare Beneficiaries With Drug Services |
153 |
Total Drug Submitted ChargeAmount |
80005 |
Total Drug Medicare AllowedAmount |
32644.92 |
Total Drug Medicare PaymentAmount |
25357.12 |
Total Drug Medicare Standardized Payment Amount |
25357.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
4383 |
Number Of Medicare Beneficiaries With Medical Services |
801 |
Total Medical Submitted Charge Amount |
708165 |
Total Medical Medicare Allowed Amount |
325031.55 |
Total Medical Medicare Payment Amount |
240377.11 |
Total Medical Medicare Standardized Payment Amount |
256325.47 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
309 |
Number Of Beneficiaries Age Greater 84 |
196 |
Number Of Female Beneficiaries |
430 |
Number Of Male Beneficiaries |
371 |
Number Of Non Hispanic White Beneficiaries |
688 |
Number Of Black or African American Beneficiaries |
75 |
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 |
715 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5252 |