| National Provider Identifier [NPI]: | 1518996081 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3435 W BROADWAY AVE |
| Street Address 2 Of The Provider | 1135 |
| City Of The Provider | ROBBINSDALE |
| Zip Code Of The Provider | 554222969 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 9216 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 431034.82 |
| Total Medicare Allowed Amount | 212643.39 |
| Total Medicare Payment Amount | 165461.34 |
| Total Medicare Standardized Payment Amount | 165326.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 45 |
| Number Of Drug Services | 8592 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 368890.12 |
| Total Drug Medicare AllowedAmount | 188220.64 |
| Total Drug Medicare PaymentAmount | 146257.34 |
| Total Drug Medicare Standardized Payment Amount | 146257.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 624 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 62144.7 |
| Total Medical Medicare Allowed Amount | 24422.75 |
| Total Medical Medicare Payment Amount | 19204 |
| Total Medical Medicare Standardized Payment Amount | 19069.08 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 48 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.091 |