| National Provider Identifier [NPI]: | 1346283439 |
| Last Name Of The Provider | THELEMAN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1643 LANCASTER DR |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | GRAPEVINE |
| Zip Code Of The Provider | 760513593 |
| 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 | 119 |
| Number Of Services | 5980 |
| Number Of Medicare Beneficiaries | 1108 |
| Total Submitted Charge Amount | 914953 |
| Total Medicare Allowed Amount | 390806.15 |
| Total Medicare Payment Amount | 284435.44 |
| Total Medicare Standardized Payment Amount | 304141.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1742 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 11550 |
| Total Drug Medicare AllowedAmount | 4253.26 |
| Total Drug Medicare PaymentAmount | 3199.47 |
| Total Drug Medicare Standardized Payment Amount | 3199.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 4238 |
| Number Of Medicare Beneficiaries With Medical Services | 1108 |
| Total Medical Submitted Charge Amount | 903403 |
| Total Medical Medicare Allowed Amount | 386552.89 |
| Total Medical Medicare Payment Amount | 281235.97 |
| Total Medical Medicare Standardized Payment Amount | 300942.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 525 |
| Number Of Beneficiaries Age 75 to 84 | 365 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 561 |
| Number Of Male Beneficiaries | 547 |
| Number Of Non Hispanic White Beneficiaries | 1010 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1042 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5568 |