| National Provider Identifier [NPI]: | 1659361699 |
| Last Name Of The Provider | NICHOLAS |
| 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 | 111 W HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKVILLE |
| Zip Code Of The Provider | 478721735 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 4235 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 177839 |
| Total Medicare Allowed Amount | 138268.83 |
| Total Medicare Payment Amount | 99042.7 |
| Total Medicare Standardized Payment Amount | 108104.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1428 |
| Number Of Medicare Beneficiaries With Drug Services | 202 |
| Total Drug Submitted ChargeAmount | 25340 |
| Total Drug Medicare AllowedAmount | 10630.3 |
| Total Drug Medicare PaymentAmount | 8876.29 |
| Total Drug Medicare Standardized Payment Amount | 8876.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 2807 |
| Number Of Medicare Beneficiaries With Medical Services | 308 |
| Total Medical Submitted Charge Amount | 152499 |
| Total Medical Medicare Allowed Amount | 127638.53 |
| Total Medical Medicare Payment Amount | 90166.41 |
| Total Medical Medicare Standardized Payment Amount | 99228.55 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 144 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9722 |