| National Provider Identifier [NPI]: | 1326085713 |
| Last Name Of The Provider | THOMPSON |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 W SHORELINE DR |
| Street Address 2 Of The Provider | SUITE 140 |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 83702 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 6991 |
| Number Of Medicare Beneficiaries | 465 |
| Total Submitted Charge Amount | 1438267.68 |
| Total Medicare Allowed Amount | 387329.99 |
| Total Medicare Payment Amount | 293369.4 |
| Total Medicare Standardized Payment Amount | 303367.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 2110 |
| Number Of Medicare Beneficiaries With Drug Services | 186 |
| Total Drug Submitted ChargeAmount | 39097.23 |
| Total Drug Medicare AllowedAmount | 4899.14 |
| Total Drug Medicare PaymentAmount | 3680.11 |
| Total Drug Medicare Standardized Payment Amount | 3680.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 4881 |
| Number Of Medicare Beneficiaries With Medical Services | 465 |
| Total Medical Submitted Charge Amount | 1399170.45 |
| Total Medical Medicare Allowed Amount | 382430.85 |
| Total Medical Medicare Payment Amount | 289689.29 |
| Total Medical Medicare Standardized Payment Amount | 299686.92 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 241 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 427 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 210 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3673 |