| National Provider Identifier [NPI]: | 1194720037 |
| Last Name Of The Provider | JOHANS |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1070 OLD DES PERES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631311865 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 9374 |
| Number Of Medicare Beneficiaries | 284 |
| Total Submitted Charge Amount | 401218.88 |
| Total Medicare Allowed Amount | 295965.44 |
| Total Medicare Payment Amount | 214800.54 |
| Total Medicare Standardized Payment Amount | 199716.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 7040 |
| Number Of Medicare Beneficiaries With Drug Services | 203 |
| Total Drug Submitted ChargeAmount | 17177.22 |
| Total Drug Medicare AllowedAmount | 13044.1 |
| Total Drug Medicare PaymentAmount | 7604.18 |
| Total Drug Medicare Standardized Payment Amount | 7604.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 2334 |
| Number Of Medicare Beneficiaries With Medical Services | 284 |
| Total Medical Submitted Charge Amount | 384041.66 |
| Total Medical Medicare Allowed Amount | 282921.34 |
| Total Medical Medicare Payment Amount | 207196.36 |
| Total Medical Medicare Standardized Payment Amount | 192112.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 262 |
| 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 | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2847 |