| National Provider Identifier [NPI]: | 1588657720 |
| Last Name Of The Provider | PLACE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1133 COLLEGE AVE |
| Street Address 2 Of The Provider | E-120 |
| City Of The Provider | MANHATTAN |
| Zip Code Of The Provider | 665022770 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 7288 |
| Number Of Medicare Beneficiaries | 3866 |
| Total Submitted Charge Amount | 483776 |
| Total Medicare Allowed Amount | 193167.9 |
| Total Medicare Payment Amount | 152081.03 |
| Total Medicare Standardized Payment Amount | 160753.52 |
| 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 | 192 |
| Number Of Medical Services | 7288 |
| Number Of Medicare Beneficiaries With Medical Services | 3866 |
| Total Medical Submitted Charge Amount | 483776 |
| Total Medical Medicare Allowed Amount | 193167.9 |
| Total Medical Medicare Payment Amount | 152081.03 |
| Total Medical Medicare Standardized Payment Amount | 160753.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 495 |
| Number Of Beneficiaries Age 65 to 74 | 1454 |
| Number Of Beneficiaries Age 75 to 84 | 1200 |
| Number Of Beneficiaries Age Greater 84 | 717 |
| Number Of Female Beneficiaries | 2570 |
| Number Of Male Beneficiaries | 1296 |
| Number Of Non Hispanic White Beneficiaries | 3656 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3209 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 657 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2506 |