| National Provider Identifier [NPI]: | 1316973381 |
| Last Name Of The Provider | THIBODEAU |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7500 MERCY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681242319 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 4512 |
| Number Of Medicare Beneficiaries | 1608 |
| Total Submitted Charge Amount | 600649 |
| Total Medicare Allowed Amount | 284775.72 |
| Total Medicare Payment Amount | 212077.34 |
| Total Medicare Standardized Payment Amount | 226596.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 9883 |
| Total Drug Medicare AllowedAmount | 4663.92 |
| Total Drug Medicare PaymentAmount | 3539.86 |
| Total Drug Medicare Standardized Payment Amount | 3539.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 4423 |
| Number Of Medicare Beneficiaries With Medical Services | 1608 |
| Total Medical Submitted Charge Amount | 590766 |
| Total Medical Medicare Allowed Amount | 280111.8 |
| Total Medical Medicare Payment Amount | 208537.48 |
| Total Medical Medicare Standardized Payment Amount | 223056.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 573 |
| Number Of Beneficiaries Age 75 to 84 | 518 |
| Number Of Beneficiaries Age Greater 84 | 339 |
| Number Of Female Beneficiaries | 851 |
| Number Of Male Beneficiaries | 757 |
| Number Of Non Hispanic White Beneficiaries | 1500 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 260 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6349 |