National Provider Identifier [NPI]: |
1437335742 |
Last Name Of The Provider |
LUCAS |
First Name Of The Provider |
TRACY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 S NATIONAL AVE |
Street Address 2 Of The Provider |
SUITE 1950 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042265 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
451 |
Number Of Medicare Beneficiaries |
215 |
Total Submitted Charge Amount |
108546.2 |
Total Medicare Allowed Amount |
25830.45 |
Total Medicare Payment Amount |
19904.37 |
Total Medicare Standardized Payment Amount |
23843.49 |
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 |
66 |
Number Of Medical Services |
451 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
108546.2 |
Total Medical Medicare Allowed Amount |
25830.45 |
Total Medical Medicare Payment Amount |
19904.37 |
Total Medical Medicare Standardized Payment Amount |
23843.49 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
113 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2907 |