| National Provider Identifier [NPI]: | 1174586960 |
| Last Name Of The Provider | THOMSEN |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 S GRAND AVE |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | GLENDORA |
| Zip Code Of The Provider | 917414205 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2128.5 |
| Number Of Medicare Beneficiaries | 304 |
| Total Submitted Charge Amount | 192956.71 |
| Total Medicare Allowed Amount | 151429.06 |
| Total Medicare Payment Amount | 106799.01 |
| Total Medicare Standardized Payment Amount | 98263.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 353.5 |
| Number Of Medicare Beneficiaries With Drug Services | 207 |
| Total Drug Submitted ChargeAmount | 11934 |
| Total Drug Medicare AllowedAmount | 2751.65 |
| Total Drug Medicare PaymentAmount | 2560.83 |
| Total Drug Medicare Standardized Payment Amount | 2560.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1775 |
| Number Of Medicare Beneficiaries With Medical Services | 304 |
| Total Medical Submitted Charge Amount | 181022.71 |
| Total Medical Medicare Allowed Amount | 148677.41 |
| Total Medical Medicare Payment Amount | 104238.18 |
| Total Medical Medicare Standardized Payment Amount | 95703.01 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 206 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 258 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9759 |