| National Provider Identifier [NPI]: | 1730275140 |
| Last Name Of The Provider | VAUGHAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33 NORTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALTON |
| Zip Code Of The Provider | 01226 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 5950 |
| Number Of Medicare Beneficiaries | 833 |
| Total Submitted Charge Amount | 401400 |
| Total Medicare Allowed Amount | 301077.29 |
| Total Medicare Payment Amount | 226536.78 |
| Total Medicare Standardized Payment Amount | 220939.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 532 |
| Number Of Medicare Beneficiaries With Drug Services | 413 |
| Total Drug Submitted ChargeAmount | 34416 |
| Total Drug Medicare AllowedAmount | 26809.47 |
| Total Drug Medicare PaymentAmount | 26261.57 |
| Total Drug Medicare Standardized Payment Amount | 26261.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 5418 |
| Number Of Medicare Beneficiaries With Medical Services | 833 |
| Total Medical Submitted Charge Amount | 366984 |
| Total Medical Medicare Allowed Amount | 274267.82 |
| Total Medical Medicare Payment Amount | 200275.21 |
| Total Medical Medicare Standardized Payment Amount | 194678.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 445 |
| Number Of Male Beneficiaries | 388 |
| Number Of Non Hispanic White Beneficiaries | 810 |
| 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 | 655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1409 |