National Provider Identifier [NPI]: |
1447370630 |
Last Name Of The Provider |
LUCAS |
First Name Of The Provider |
MARLIE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1033 N PARKWAY FRONTAGE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKELAND |
Zip Code Of The Provider |
338030401 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
457 |
Number Of Medicare Beneficiaries |
251 |
Total Submitted Charge Amount |
47901 |
Total Medicare Allowed Amount |
22935.82 |
Total Medicare Payment Amount |
15359.83 |
Total Medicare Standardized Payment Amount |
18762.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
130 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
769 |
Total Drug Medicare AllowedAmount |
65.73 |
Total Drug Medicare PaymentAmount |
45.74 |
Total Drug Medicare Standardized Payment Amount |
45.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
327 |
Number Of Medicare Beneficiaries With Medical Services |
251 |
Total Medical Submitted Charge Amount |
47132 |
Total Medical Medicare Allowed Amount |
22870.09 |
Total Medical Medicare Payment Amount |
15314.09 |
Total Medical Medicare Standardized Payment Amount |
18716.27 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1623 |