| National Provider Identifier [NPI]: | 1326036112 |
| Last Name Of The Provider | LARGEN |
| First Name Of The Provider | REX |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5533 S 27TH STREET |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 685121664 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 7448 |
| Number Of Medicare Beneficiaries | 1130 |
| Total Submitted Charge Amount | 784875 |
| Total Medicare Allowed Amount | 374693.74 |
| Total Medicare Payment Amount | 265202.78 |
| Total Medicare Standardized Payment Amount | 285993.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 747 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 6967 |
| Total Drug Medicare AllowedAmount | 4802.36 |
| Total Drug Medicare PaymentAmount | 3634.92 |
| Total Drug Medicare Standardized Payment Amount | 3634.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 6701 |
| Number Of Medicare Beneficiaries With Medical Services | 1130 |
| Total Medical Submitted Charge Amount | 777908 |
| Total Medical Medicare Allowed Amount | 369891.38 |
| Total Medical Medicare Payment Amount | 261567.86 |
| Total Medical Medicare Standardized Payment Amount | 282358.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 538 |
| Number Of Beneficiaries Age 75 to 84 | 384 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 567 |
| Number Of Male Beneficiaries | 563 |
| Number Of Non Hispanic White Beneficiaries | 1106 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 1057 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8968 |