| National Provider Identifier [NPI]: | 1225080005 |
| Last Name Of The Provider | MCCORMACK |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 53 MARION RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAREHAM |
| Zip Code Of The Provider | 025711483 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 3750 |
| Number Of Medicare Beneficiaries | 539 |
| Total Submitted Charge Amount | 442894.62 |
| Total Medicare Allowed Amount | 200439.93 |
| Total Medicare Payment Amount | 146883.36 |
| Total Medicare Standardized Payment Amount | 144422.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 236 |
| Number Of Medicare Beneficiaries With Drug Services | 211 |
| Total Drug Submitted ChargeAmount | 12719 |
| Total Drug Medicare AllowedAmount | 7514.06 |
| Total Drug Medicare PaymentAmount | 7170.18 |
| Total Drug Medicare Standardized Payment Amount | 7170.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 3514 |
| Number Of Medicare Beneficiaries With Medical Services | 539 |
| Total Medical Submitted Charge Amount | 430175.62 |
| Total Medical Medicare Allowed Amount | 192925.87 |
| Total Medical Medicare Payment Amount | 139713.18 |
| Total Medical Medicare Standardized Payment Amount | 137252.55 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 311 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 488 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0446 |