| National Provider Identifier [NPI]: | 1699705004 |
| Last Name Of The Provider | THOENDEL |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 336 S 9TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAVID CITY |
| Zip Code Of The Provider | 686322116 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 4889 |
| Number Of Medicare Beneficiaries | 519 |
| Total Submitted Charge Amount | 347004.55 |
| Total Medicare Allowed Amount | 154903.46 |
| Total Medicare Payment Amount | 109361.3 |
| Total Medicare Standardized Payment Amount | 119623.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 946 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 14402 |
| Total Drug Medicare AllowedAmount | 7766.05 |
| Total Drug Medicare PaymentAmount | 7111.31 |
| Total Drug Medicare Standardized Payment Amount | 7111.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 3943 |
| Number Of Medicare Beneficiaries With Medical Services | 519 |
| Total Medical Submitted Charge Amount | 332602.55 |
| Total Medical Medicare Allowed Amount | 147137.41 |
| Total Medical Medicare Payment Amount | 102249.99 |
| Total Medical Medicare Standardized Payment Amount | 112512.58 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 450 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9688 |