National Provider Identifier [NPI]: |
1790981702 |
Last Name Of The Provider |
LUKA |
First Name Of The Provider |
LANCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N 1ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627810001 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
128 |
Number Of Services |
4996 |
Number Of Medicare Beneficiaries |
2423 |
Total Submitted Charge Amount |
971955 |
Total Medicare Allowed Amount |
154661.02 |
Total Medicare Payment Amount |
120796.28 |
Total Medicare Standardized Payment Amount |
126471.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
128 |
Number Of Medical Services |
4996 |
Number Of Medicare Beneficiaries With Medical Services |
2423 |
Total Medical Submitted Charge Amount |
971955 |
Total Medical Medicare Allowed Amount |
154661.02 |
Total Medical Medicare Payment Amount |
120796.28 |
Total Medical Medicare Standardized Payment Amount |
126471.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
606 |
Number Of Beneficiaries Age 65 to 74 |
721 |
Number Of Beneficiaries Age 75 to 84 |
655 |
Number Of Beneficiaries Age Greater 84 |
441 |
Number Of Female Beneficiaries |
1363 |
Number Of Male Beneficiaries |
1060 |
Number Of Non Hispanic White Beneficiaries |
2185 |
Number Of Black or African American Beneficiaries |
188 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
26 |
Number Of Beneficiaries With Medicare Only Entitlement |
1596 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
827 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.079 |