| National Provider Identifier [NPI]: | 1811079437 |
| Last Name Of The Provider | GLEASON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1015 UNION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOONE |
| Zip Code Of The Provider | 500364821 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 5883 |
| Number Of Medicare Beneficiaries | 1976 |
| Total Submitted Charge Amount | 655481 |
| Total Medicare Allowed Amount | 140997.6 |
| Total Medicare Payment Amount | 111508.31 |
| Total Medicare Standardized Payment Amount | 117832.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 5883 |
| Number Of Medicare Beneficiaries With Medical Services | 1976 |
| Total Medical Submitted Charge Amount | 655481 |
| Total Medical Medicare Allowed Amount | 140997.6 |
| Total Medical Medicare Payment Amount | 111508.31 |
| Total Medical Medicare Standardized Payment Amount | 117832.22 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 233 |
| Number Of Beneficiaries Age 65 to 74 | 722 |
| Number Of Beneficiaries Age 75 to 84 | 621 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1304 |
| Number Of Male Beneficiaries | 672 |
| Number Of Non Hispanic White Beneficiaries | 1941 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1622 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0762 |