| National Provider Identifier [NPI]: | 1740339464 |
| Last Name Of The Provider | NETTER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12196 COUNTY ROAD 512 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FELLSMERE |
| Zip Code Of The Provider | 329485463 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 235 |
| Number Of Medicare Beneficiaries | 134 |
| Total Submitted Charge Amount | 37537.24 |
| Total Medicare Allowed Amount | 18637.13 |
| Total Medicare Payment Amount | 13132.01 |
| Total Medicare Standardized Payment Amount | 12975.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 190.76 |
| Total Drug Medicare AllowedAmount | 53.22 |
| Total Drug Medicare PaymentAmount | 39.8 |
| Total Drug Medicare Standardized Payment Amount | 39.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 207 |
| Number Of Medicare Beneficiaries With Medical Services | 134 |
| Total Medical Submitted Charge Amount | 37346.48 |
| Total Medical Medicare Allowed Amount | 18583.91 |
| Total Medical Medicare Payment Amount | 13092.21 |
| Total Medical Medicare Standardized Payment Amount | 12935.27 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 112 |
| 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 | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1521 |