National Provider Identifier [NPI]: |
1629001524 |
Last Name Of The Provider |
LOGUE |
First Name Of The Provider |
DREW |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1540 FLORIDA AVE |
Street Address 2 Of The Provider |
STE 212 |
City Of The Provider |
MODESTO |
Zip Code Of The Provider |
953504430 |
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 |
22 |
Number Of Services |
1223 |
Number Of Medicare Beneficiaries |
532 |
Total Submitted Charge Amount |
479766 |
Total Medicare Allowed Amount |
210901.6 |
Total Medicare Payment Amount |
158316.45 |
Total Medicare Standardized Payment Amount |
153886.94 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
427 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
74 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
414 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.25 |