| National Provider Identifier [NPI]: | 1700805454 |
| Last Name Of The Provider | CASTILLO |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 705 S UNIVERSITY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | BEAVER DAM |
| Zip Code Of The Provider | 539163053 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2805 |
| Number Of Medicare Beneficiaries | 1051 |
| Total Submitted Charge Amount | 616056.35 |
| Total Medicare Allowed Amount | 340446.96 |
| Total Medicare Payment Amount | 237460.69 |
| Total Medicare Standardized Payment Amount | 249765.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 2805 |
| Number Of Medicare Beneficiaries With Medical Services | 1051 |
| Total Medical Submitted Charge Amount | 616056.35 |
| Total Medical Medicare Allowed Amount | 340446.96 |
| Total Medical Medicare Payment Amount | 237460.69 |
| Total Medical Medicare Standardized Payment Amount | 249765.39 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 354 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 656 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 1030 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 975 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0517 |