National Provider Identifier [NPI]: |
1790787125 |
Last Name Of The Provider |
LUCE |
First Name Of The Provider |
KATHLEEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1715 INDIAN WOOD CIR |
Street Address 2 Of The Provider |
STE 200, OFFICE 266 & 265 |
City Of The Provider |
MAUMEE |
Zip Code Of The Provider |
435374055 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
789 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
79321.19 |
Total Medicare Allowed Amount |
64013.79 |
Total Medicare Payment Amount |
46132.53 |
Total Medicare Standardized Payment Amount |
48002.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
1815.51 |
Total Drug Medicare AllowedAmount |
1389.23 |
Total Drug Medicare PaymentAmount |
1359.81 |
Total Drug Medicare Standardized Payment Amount |
1359.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
732 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
77505.68 |
Total Medical Medicare Allowed Amount |
62624.56 |
Total Medical Medicare Payment Amount |
44772.72 |
Total Medical Medicare Standardized Payment Amount |
46642.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
154 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.485 |