| National Provider Identifier [NPI]: | 1598855967 |
| Last Name Of The Provider | POE |
| First Name Of The Provider | THADDAEUS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5250 EAST US 36 |
| Street Address 2 Of The Provider | SUITE 610 |
| City Of The Provider | AVON |
| Zip Code Of The Provider | 46123 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 3282 |
| Number Of Medicare Beneficiaries | 471 |
| Total Submitted Charge Amount | 222890.04 |
| Total Medicare Allowed Amount | 150534.56 |
| Total Medicare Payment Amount | 114836.91 |
| Total Medicare Standardized Payment Amount | 120873.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 322 |
| Number Of Medicare Beneficiaries With Drug Services | 194 |
| Total Drug Submitted ChargeAmount | 15377.04 |
| Total Drug Medicare AllowedAmount | 11904.15 |
| Total Drug Medicare PaymentAmount | 11577.1 |
| Total Drug Medicare Standardized Payment Amount | 11577.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 2960 |
| Number Of Medicare Beneficiaries With Medical Services | 470 |
| Total Medical Submitted Charge Amount | 207513 |
| Total Medical Medicare Allowed Amount | 138630.41 |
| Total Medical Medicare Payment Amount | 103259.81 |
| Total Medical Medicare Standardized Payment Amount | 109296.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 228 |
| 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 | 453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9897 |