National Provider Identifier [NPI]: |
1629152152 |
Last Name Of The Provider |
DRAKE |
First Name Of The Provider |
LUCAS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8051 SOUTH EMERSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462378632 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
3401 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
519196 |
Total Medicare Allowed Amount |
140145.53 |
Total Medicare Payment Amount |
108326.59 |
Total Medicare Standardized Payment Amount |
115786.67 |
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 |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
311 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
506 |
Number Of Black or African American Beneficiaries |
|
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 |
419 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6161 |