| National Provider Identifier [NPI]: | 1558399022 |
| Last Name Of The Provider | MERCORA |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1530 WOODBOURNE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEVITTOWN |
| Zip Code Of The Provider | 190571532 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1377 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 148440.02 |
| Total Medicare Allowed Amount | 74523.84 |
| Total Medicare Payment Amount | 54286.1 |
| Total Medicare Standardized Payment Amount | 44940.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 2680 |
| Total Drug Medicare AllowedAmount | 772.17 |
| Total Drug Medicare PaymentAmount | 711.29 |
| Total Drug Medicare Standardized Payment Amount | 711.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1277 |
| Number Of Medicare Beneficiaries With Medical Services | 192 |
| Total Medical Submitted Charge Amount | 145760.02 |
| Total Medical Medicare Allowed Amount | 73751.67 |
| Total Medical Medicare Payment Amount | 53574.81 |
| Total Medical Medicare Standardized Payment Amount | 44229.23 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| 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 | 134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9266 |