| National Provider Identifier [NPI]: | 1568448884 |
| Last Name Of The Provider | ADE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 30TH AVE |
| Street Address 2 Of The Provider | STE 12 |
| City Of The Provider | MOLINE |
| Zip Code Of The Provider | 612655975 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 22015 |
| Number Of Medicare Beneficiaries | 1990 |
| Total Submitted Charge Amount | 708844.73 |
| Total Medicare Allowed Amount | 690527.58 |
| Total Medicare Payment Amount | 559672.92 |
| Total Medicare Standardized Payment Amount | 574313.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 722 |
| Number Of Medicare Beneficiaries With Drug Services | 329 |
| Total Drug Submitted ChargeAmount | 10594.2 |
| Total Drug Medicare AllowedAmount | 10353.78 |
| Total Drug Medicare PaymentAmount | 9643.69 |
| Total Drug Medicare Standardized Payment Amount | 9643.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 21293 |
| Number Of Medicare Beneficiaries With Medical Services | 1990 |
| Total Medical Submitted Charge Amount | 698250.53 |
| Total Medical Medicare Allowed Amount | 680173.8 |
| Total Medical Medicare Payment Amount | 550029.23 |
| Total Medical Medicare Standardized Payment Amount | 564669.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 845 |
| Number Of Beneficiaries Age 75 to 84 | 691 |
| Number Of Beneficiaries Age Greater 84 | 290 |
| Number Of Female Beneficiaries | 1013 |
| Number Of Male Beneficiaries | 977 |
| Number Of Non Hispanic White Beneficiaries | 1838 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1756 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2681 |