| National Provider Identifier [NPI]: | 1659375434 |
| Last Name Of The Provider | FLETCHER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 9381 |
| Number Of Medicare Beneficiaries | 3787 |
| Total Submitted Charge Amount | 928071.6 |
| Total Medicare Allowed Amount | 373556.53 |
| Total Medicare Payment Amount | 315242.36 |
| Total Medicare Standardized Payment Amount | 317161.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3147 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 9299.6 |
| Total Drug Medicare AllowedAmount | 1836.72 |
| Total Drug Medicare PaymentAmount | 1413.12 |
| Total Drug Medicare Standardized Payment Amount | 1413.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 6234 |
| Number Of Medicare Beneficiaries With Medical Services | 3787 |
| Total Medical Submitted Charge Amount | 918772 |
| Total Medical Medicare Allowed Amount | 371719.81 |
| Total Medical Medicare Payment Amount | 313829.24 |
| Total Medical Medicare Standardized Payment Amount | 315748.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 486 |
| Number Of Beneficiaries Age 65 to 74 | 1927 |
| Number Of Beneficiaries Age 75 to 84 | 973 |
| Number Of Beneficiaries Age Greater 84 | 401 |
| Number Of Female Beneficiaries | 3005 |
| Number Of Male Beneficiaries | 782 |
| Number Of Non Hispanic White Beneficiaries | 2931 |
| Number Of Black or African American Beneficiaries | 339 |
| Number Of AsianPacific Islander Beneficiaries | 73 |
| Number Of Hispanic Beneficiaries | 403 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 592 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3225 |