| National Provider Identifier [NPI]: | 1831171321 | 
| Last Name Of The Provider | TOMLIN | 
| First Name Of The Provider | MICHAEL | 
| 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 | 2001 W 86TH ST | 
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS | 
| Zip Code Of The Provider | 462601902 | 
| State Code Of The Provider | IN | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Anesthesiology | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 51 | 
| Number Of Services | 129 | 
| Number Of Medicare Beneficiaries | 120 | 
| Total Submitted Charge Amount | 146020.6 | 
| Total Medicare Allowed Amount | 33722.73 | 
| Total Medicare Payment Amount | 26323.4 | 
| Total Medicare Standardized Payment Amount | 27532.45 | 
| 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 | 51 | 
| Number Of Medical Services | 129 | 
| Number Of Medicare Beneficiaries With Medical Services | 120 | 
| Total Medical Submitted Charge Amount | 146020.6 | 
| Total Medical Medicare Allowed Amount | 33722.73 | 
| Total Medical Medicare Payment Amount | 26323.4 | 
| Total Medical Medicare Standardized Payment Amount | 27532.45 | 
| Average Age Of Beneficiaries | 69 | 
| Number Of Beneficiaries Age Less65 | 29 | 
| Number Of Beneficiaries Age 65 to 74 | 53 | 
| Number Of Beneficiaries Age 75 to 84 | 27 | 
| Number Of Beneficiaries Age Greater 84 | 11 | 
| Number Of Female Beneficiaries | 78 | 
| Number Of Male Beneficiaries | 42 | 
| Number Of Non Hispanic White Beneficiaries | 107 | 
| 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 | 85 | 
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 | 
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 15 | 
| Percent Of With Asthma | 13 | 
| Percent Of With Cancer | 17 | 
| Percent Of With Heart Failure | 25 | 
| Percent Of With Chronic Kidney Disease | 33 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 | 
| Percent Of With Depression | 43 | 
| Percent Of With Diabetes | 38 | 
| Percent Of With Hyperlipidemia | 58 | 
| Percent Of With Hypertension | 74 | 
| Percent Of With Ischemic Heart Disease | 36 | 
| Percent Of With Osteoporosis | 10 | 
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 | 
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6749 |