| National Provider Identifier [NPI]: | 1306811872 |
| Last Name Of The Provider | ROBERTSON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 680 E FREMONT MEDICAL PARK DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 680252309 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 6802.5 |
| Number Of Medicare Beneficiaries | 873 |
| Total Submitted Charge Amount | 523485.5 |
| Total Medicare Allowed Amount | 302381.34 |
| Total Medicare Payment Amount | 228731.15 |
| Total Medicare Standardized Payment Amount | 246967.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 541.5 |
| Number Of Medicare Beneficiaries With Drug Services | 350 |
| Total Drug Submitted ChargeAmount | 15725.5 |
| Total Drug Medicare AllowedAmount | 10306.88 |
| Total Drug Medicare PaymentAmount | 9999.16 |
| Total Drug Medicare Standardized Payment Amount | 9999.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 6261 |
| Number Of Medicare Beneficiaries With Medical Services | 873 |
| Total Medical Submitted Charge Amount | 507760 |
| Total Medical Medicare Allowed Amount | 292074.46 |
| Total Medical Medicare Payment Amount | 218731.99 |
| Total Medical Medicare Standardized Payment Amount | 236968.64 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 345 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 494 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 858 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 767 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2167 |