| National Provider Identifier [NPI]: | 1487807566 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 229 HARRIS LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | YANTIS |
| Zip Code Of The Provider | 754979730 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Independent Diagnostic Testing Facility |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 6444 |
| Number Of Medicare Beneficiaries | 1508 |
| Total Submitted Charge Amount | 722840 |
| Total Medicare Allowed Amount | 309957.75 |
| Total Medicare Payment Amount | 242474.08 |
| Total Medicare Standardized Payment Amount | 258119.52 |
| 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 | 6 |
| Number Of Medical Services | 6444 |
| Number Of Medicare Beneficiaries With Medical Services | 1508 |
| Total Medical Submitted Charge Amount | 722840 |
| Total Medical Medicare Allowed Amount | 309957.75 |
| Total Medical Medicare Payment Amount | 242474.08 |
| Total Medical Medicare Standardized Payment Amount | 258119.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 246 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 496 |
| Number Of Beneficiaries Age Greater 84 | 264 |
| Number Of Female Beneficiaries | 917 |
| Number Of Male Beneficiaries | 591 |
| Number Of Non Hispanic White Beneficiaries | 1203 |
| Number Of Black or African American Beneficiaries | 211 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1082 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 426 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 73 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2481 |