| National Provider Identifier [NPI]: | 1558388090 |
| Last Name Of The Provider | BUCKLEY |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 175 SHERMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 06511 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 2411 |
| Number Of Medicare Beneficiaries | 591 |
| Total Submitted Charge Amount | 433972 |
| Total Medicare Allowed Amount | 196761.14 |
| Total Medicare Payment Amount | 146617.56 |
| Total Medicare Standardized Payment Amount | 137718.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 281 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 73830 |
| Total Drug Medicare AllowedAmount | 27262.81 |
| Total Drug Medicare PaymentAmount | 20984.14 |
| Total Drug Medicare Standardized Payment Amount | 20984.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 2130 |
| Number Of Medicare Beneficiaries With Medical Services | 591 |
| Total Medical Submitted Charge Amount | 360142 |
| Total Medical Medicare Allowed Amount | 169498.33 |
| Total Medical Medicare Payment Amount | 125633.42 |
| Total Medical Medicare Standardized Payment Amount | 116734.55 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 499 |
| Number Of Non Hispanic White Beneficiaries | 532 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 540 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2921 |