| National Provider Identifier [NPI]: | 1083613491 |
| Last Name Of The Provider | CORBETT |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 7TH ST NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEVILS LAKE |
| Zip Code Of The Provider | 583012719 |
| State Code Of The Provider | ND |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 53639 |
| Number Of Medicare Beneficiaries | 589 |
| Total Submitted Charge Amount | 1474606.46 |
| Total Medicare Allowed Amount | 427892.03 |
| Total Medicare Payment Amount | 282806.4 |
| Total Medicare Standardized Payment Amount | 287889.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 32 |
| Number Of Drug Services | 44787 |
| Number Of Medicare Beneficiaries With Drug Services | 148 |
| Total Drug Submitted ChargeAmount | 547571.96 |
| Total Drug Medicare AllowedAmount | 183460.26 |
| Total Drug Medicare PaymentAmount | 103038.15 |
| Total Drug Medicare Standardized Payment Amount | 103038.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 8852 |
| Number Of Medicare Beneficiaries With Medical Services | 589 |
| Total Medical Submitted Charge Amount | 927034.5 |
| Total Medical Medicare Allowed Amount | 244431.77 |
| Total Medical Medicare Payment Amount | 179768.25 |
| Total Medical Medicare Standardized Payment Amount | 184851.6 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 214 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 545 |
| Number Of Black or African American Beneficiaries | |
| 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 | 471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1488 |