| National Provider Identifier [NPI]: | 1427199207 |
| Last Name Of The Provider | FONTENOT |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D, |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 417 E. LINCOLN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | VILLE PLATTE |
| Zip Code Of The Provider | 705863431 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 2586 |
| Number Of Medicare Beneficiaries | 575 |
| Total Submitted Charge Amount | 234129 |
| Total Medicare Allowed Amount | 198177.05 |
| Total Medicare Payment Amount | 141871.23 |
| Total Medicare Standardized Payment Amount | 152495.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 134 |
| Total Drug Submitted ChargeAmount | 5485 |
| Total Drug Medicare AllowedAmount | 2688.83 |
| Total Drug Medicare PaymentAmount | 2574.03 |
| Total Drug Medicare Standardized Payment Amount | 2574.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2315 |
| Number Of Medicare Beneficiaries With Medical Services | 575 |
| Total Medical Submitted Charge Amount | 228644 |
| Total Medical Medicare Allowed Amount | 195488.22 |
| Total Medical Medicare Payment Amount | 139297.2 |
| Total Medical Medicare Standardized Payment Amount | 149921.22 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 495 |
| 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 | 341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2747 |