| National Provider Identifier [NPI]: | 1710157615 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | ELISSA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 MORMON MILL RD |
| Street Address 2 Of The Provider | BUILDING B, STE. 2 |
| City Of The Provider | MARBLE FALLS |
| Zip Code Of The Provider | 786544175 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3386 |
| Number Of Medicare Beneficiaries | 1579 |
| Total Submitted Charge Amount | 456038.34 |
| Total Medicare Allowed Amount | 186449.43 |
| Total Medicare Payment Amount | 126177.5 |
| Total Medicare Standardized Payment Amount | 131749.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 7761.98 |
| Total Drug Medicare AllowedAmount | 6589.44 |
| Total Drug Medicare PaymentAmount | 5050.95 |
| Total Drug Medicare Standardized Payment Amount | 5050.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3260 |
| Number Of Medicare Beneficiaries With Medical Services | 1579 |
| Total Medical Submitted Charge Amount | 448276.36 |
| Total Medical Medicare Allowed Amount | 179859.99 |
| Total Medical Medicare Payment Amount | 121126.55 |
| Total Medical Medicare Standardized Payment Amount | 126698.85 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 547 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 766 |
| Number Of Male Beneficiaries | 813 |
| Number Of Non Hispanic White Beneficiaries | 1519 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1333 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4892 |