National Provider Identifier [NPI]: |
1518918895 |
Last Name Of The Provider |
LUCIO |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12112 RANCHO VISTOSO BLVD 150-221 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
85755 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
150 |
Number Of Services |
2271 |
Number Of Medicare Beneficiaries |
1443 |
Total Submitted Charge Amount |
366515 |
Total Medicare Allowed Amount |
108789.19 |
Total Medicare Payment Amount |
81365.2 |
Total Medicare Standardized Payment Amount |
83803.36 |
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 |
150 |
Number Of Medical Services |
2271 |
Number Of Medicare Beneficiaries With Medical Services |
1443 |
Total Medical Submitted Charge Amount |
366515 |
Total Medical Medicare Allowed Amount |
108789.19 |
Total Medical Medicare Payment Amount |
81365.2 |
Total Medical Medicare Standardized Payment Amount |
83803.36 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
201 |
Number Of Beneficiaries Age 65 to 74 |
543 |
Number Of Beneficiaries Age 75 to 84 |
486 |
Number Of Beneficiaries Age Greater 84 |
213 |
Number Of Female Beneficiaries |
831 |
Number Of Male Beneficiaries |
612 |
Number Of Non Hispanic White Beneficiaries |
994 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
322 |
Number Of American Indian Alaska Native Beneficiaries |
80 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1071 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
372 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7236 |