| National Provider Identifier [NPI]: | 1306065388 |
| Last Name Of The Provider | THOMAS |
| First Name Of The Provider | JUSTIN |
| 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 | 39000 BOB HOPE DR |
| Street Address 2 Of The Provider | WRIGHT BLDG 201 |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 922703221 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 2335 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 701483.56 |
| Total Medicare Allowed Amount | 206836.35 |
| Total Medicare Payment Amount | 159622.61 |
| Total Medicare Standardized Payment Amount | 157087.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2335 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 701483.56 |
| Total Medical Medicare Allowed Amount | 206836.35 |
| Total Medical Medicare Payment Amount | 159622.61 |
| Total Medical Medicare Standardized Payment Amount | 157087.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 301 |
| Number Of Male Beneficiaries | 322 |
| Number Of Non Hispanic White Beneficiaries | 565 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9851 |