| National Provider Identifier [NPI]: | 1265484679 |
| Last Name Of The Provider | TOMES |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 S WABASHA ST |
| Street Address 2 Of The Provider | MAIL STOP 31300A - HEALTHPARTNERS ST. PAUL CLINIC |
| City Of The Provider | ST. PAUL |
| Zip Code Of The Provider | 551071805 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 909 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 78720 |
| Total Medicare Allowed Amount | 29322.19 |
| Total Medicare Payment Amount | 21023.27 |
| Total Medicare Standardized Payment Amount | 21658.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 377 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 2827 |
| Total Drug Medicare AllowedAmount | 1254.73 |
| Total Drug Medicare PaymentAmount | 1144.43 |
| Total Drug Medicare Standardized Payment Amount | 1144.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 75893 |
| Total Medical Medicare Allowed Amount | 28067.46 |
| Total Medical Medicare Payment Amount | 19878.84 |
| Total Medical Medicare Standardized Payment Amount | 20514.46 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 23 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 57 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.2224 |