| National Provider Identifier [NPI]: | 1669554176 |
| Last Name Of The Provider | THIES |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 913 SHEIDLEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BONNER SPRINGS |
| Zip Code Of The Provider | 660129514 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 1508 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 277771 |
| Total Medicare Allowed Amount | 93830.86 |
| Total Medicare Payment Amount | 66723.85 |
| Total Medicare Standardized Payment Amount | 71173.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 362 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 9803 |
| Total Drug Medicare AllowedAmount | 3264.52 |
| Total Drug Medicare PaymentAmount | 3118.11 |
| Total Drug Medicare Standardized Payment Amount | 3118.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1146 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 267968 |
| Total Medical Medicare Allowed Amount | 90566.34 |
| Total Medical Medicare Payment Amount | 63605.74 |
| Total Medical Medicare Standardized Payment Amount | 68054.98 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 204 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0767 |