| National Provider Identifier [NPI]: | 1053300863 |
| Last Name Of The Provider | HEADSTREAM |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1665 ANTILLEY RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796065265 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 14091 |
| Number Of Medicare Beneficiaries | 1901 |
| Total Submitted Charge Amount | 1530771 |
| Total Medicare Allowed Amount | 684061.34 |
| Total Medicare Payment Amount | 523372.41 |
| Total Medicare Standardized Payment Amount | 553656.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 5003 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 56922 |
| Total Drug Medicare AllowedAmount | 20245.31 |
| Total Drug Medicare PaymentAmount | 16578.42 |
| Total Drug Medicare Standardized Payment Amount | 16578.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 9088 |
| Number Of Medicare Beneficiaries With Medical Services | 1901 |
| Total Medical Submitted Charge Amount | 1473849 |
| Total Medical Medicare Allowed Amount | 663816.03 |
| Total Medical Medicare Payment Amount | 506793.99 |
| Total Medical Medicare Standardized Payment Amount | 537078.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 716 |
| Number Of Beneficiaries Age 75 to 84 | 687 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 1033 |
| Number Of Male Beneficiaries | 868 |
| Number Of Non Hispanic White Beneficiaries | 1697 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 134 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4696 |