| National Provider Identifier [NPI]: | 1801892211 |
| Last Name Of The Provider | HRISOMALOS |
| First Name Of The Provider | TOM |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 LANDMARK AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 47403 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 59539 |
| Number Of Medicare Beneficiaries | 7033 |
| Total Submitted Charge Amount | 2133330 |
| Total Medicare Allowed Amount | 798279.95 |
| Total Medicare Payment Amount | 745921.87 |
| Total Medicare Standardized Payment Amount | 757771.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 235 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 8614 |
| Total Drug Medicare AllowedAmount | 4169.29 |
| Total Drug Medicare PaymentAmount | 3702.75 |
| Total Drug Medicare Standardized Payment Amount | 3702.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 59304 |
| Number Of Medicare Beneficiaries With Medical Services | 7033 |
| Total Medical Submitted Charge Amount | 2124716 |
| Total Medical Medicare Allowed Amount | 794110.66 |
| Total Medical Medicare Payment Amount | 742219.12 |
| Total Medical Medicare Standardized Payment Amount | 754068.94 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 957 |
| Number Of Beneficiaries Age 65 to 74 | 3147 |
| Number Of Beneficiaries Age 75 to 84 | 2035 |
| Number Of Beneficiaries Age Greater 84 | 894 |
| Number Of Female Beneficiaries | 4192 |
| Number Of Male Beneficiaries | 2841 |
| Number Of Non Hispanic White Beneficiaries | 6809 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 91 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1094 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| 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 | 1.0431 |