| National Provider Identifier [NPI]: | 1316932957 |
| Last Name Of The Provider | LUCIO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2505 MISSION DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | JEFFERSON CITY |
| Zip Code Of The Provider | 651099508 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 11197 |
| Number Of Medicare Beneficiaries | 910 |
| Total Submitted Charge Amount | 1221762.4 |
| Total Medicare Allowed Amount | 311640.8 |
| Total Medicare Payment Amount | 232122.26 |
| Total Medicare Standardized Payment Amount | 255016.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 7666 |
| Number Of Medicare Beneficiaries With Drug Services | 546 |
| Total Drug Submitted ChargeAmount | 56109.4 |
| Total Drug Medicare AllowedAmount | 12983.61 |
| Total Drug Medicare PaymentAmount | 9687.86 |
| Total Drug Medicare Standardized Payment Amount | 9687.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3531 |
| Number Of Medicare Beneficiaries With Medical Services | 908 |
| Total Medical Submitted Charge Amount | 1165653 |
| Total Medical Medicare Allowed Amount | 298657.19 |
| Total Medical Medicare Payment Amount | 222434.4 |
| Total Medical Medicare Standardized Payment Amount | 245328.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 280 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 227 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 577 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 709 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2028 |