| National Provider Identifier [NPI]: | 1508976754 |
| Last Name Of The Provider | LUNDQUIST |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 W STOUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICE LAKE |
| Zip Code Of The Provider | 548685000 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 1339 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 167413.67 |
| Total Medicare Allowed Amount | 69668.84 |
| Total Medicare Payment Amount | 49144.82 |
| Total Medicare Standardized Payment Amount | 51209.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 301 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 6570.05 |
| Total Drug Medicare AllowedAmount | 3913.11 |
| Total Drug Medicare PaymentAmount | 3400.32 |
| Total Drug Medicare Standardized Payment Amount | 3400.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1038 |
| Number Of Medicare Beneficiaries With Medical Services | 307 |
| Total Medical Submitted Charge Amount | 160843.62 |
| Total Medical Medicare Allowed Amount | 65755.73 |
| Total Medical Medicare Payment Amount | 45744.5 |
| Total Medical Medicare Standardized Payment Amount | 47809.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9631 |