| National Provider Identifier [NPI]: | 1508980657 |
| Last Name Of The Provider | HEWITT |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6717 N OAK TRFY |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLADSTONE |
| Zip Code Of The Provider | 641183346 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2255 |
| Number Of Medicare Beneficiaries | 707 |
| Total Submitted Charge Amount | 196533.5 |
| Total Medicare Allowed Amount | 118217.15 |
| Total Medicare Payment Amount | 82608.04 |
| Total Medicare Standardized Payment Amount | 85286.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 591.5 |
| Total Drug Medicare AllowedAmount | 56.5 |
| Total Drug Medicare PaymentAmount | 40.42 |
| Total Drug Medicare Standardized Payment Amount | 40.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2202 |
| Number Of Medicare Beneficiaries With Medical Services | 707 |
| Total Medical Submitted Charge Amount | 195942 |
| Total Medical Medicare Allowed Amount | 118160.65 |
| Total Medical Medicare Payment Amount | 82567.62 |
| Total Medical Medicare Standardized Payment Amount | 85246.16 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 406 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 673 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 663 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4586 |