| National Provider Identifier [NPI]: | 1750331369 |
| Last Name Of The Provider | CHEATLE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 933 E PIERCE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COUNCIL BLUFFS |
| Zip Code Of The Provider | 515034626 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2275 |
| Number Of Medicare Beneficiaries | 1741 |
| Total Submitted Charge Amount | 1459528 |
| Total Medicare Allowed Amount | 280971.52 |
| Total Medicare Payment Amount | 209275.29 |
| Total Medicare Standardized Payment Amount | 223548.22 |
| 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 | 35 |
| Number Of Medical Services | 2275 |
| Number Of Medicare Beneficiaries With Medical Services | 1741 |
| Total Medical Submitted Charge Amount | 1459528 |
| Total Medical Medicare Allowed Amount | 280971.52 |
| Total Medical Medicare Payment Amount | 209275.29 |
| Total Medical Medicare Standardized Payment Amount | 223548.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 459 |
| Number Of Beneficiaries Age 75 to 84 | 504 |
| Number Of Beneficiaries Age Greater 84 | 417 |
| Number Of Female Beneficiaries | 1060 |
| Number Of Male Beneficiaries | 681 |
| Number Of Non Hispanic White Beneficiaries | 1622 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1272 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 469 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6017 |