| National Provider Identifier [NPI]: | 1982661211 |
| Last Name Of The Provider | HUISMAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7501 SURRATTS RD |
| Street Address 2 Of The Provider | #308 |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 20735 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 4566 |
| Number Of Medicare Beneficiaries | 969 |
| Total Submitted Charge Amount | 735016.9 |
| Total Medicare Allowed Amount | 342198.22 |
| Total Medicare Payment Amount | 251722.48 |
| Total Medicare Standardized Payment Amount | 241006.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 657 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 119325.98 |
| Total Drug Medicare AllowedAmount | 53047.24 |
| Total Drug Medicare PaymentAmount | 41525.32 |
| Total Drug Medicare Standardized Payment Amount | 41525.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 3909 |
| Number Of Medicare Beneficiaries With Medical Services | 969 |
| Total Medical Submitted Charge Amount | 615690.92 |
| Total Medical Medicare Allowed Amount | 289150.98 |
| Total Medical Medicare Payment Amount | 210197.16 |
| Total Medical Medicare Standardized Payment Amount | 199481.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 472 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 752 |
| Number Of Non Hispanic White Beneficiaries | 504 |
| Number Of Black or African American Beneficiaries | 434 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 906 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2293 |