| National Provider Identifier [NPI]: | 1992947535 |
| Last Name Of The Provider | LUCKETTE |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4275 BURNHAM AVE |
| Street Address 2 Of The Provider | SUITE 255 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891195488 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 169 |
| Number Of Medicare Beneficiaries | 121 |
| Total Submitted Charge Amount | 21905 |
| Total Medicare Allowed Amount | 9961.1 |
| Total Medicare Payment Amount | 6010.61 |
| Total Medicare Standardized Payment Amount | 7556.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 330 |
| Total Drug Medicare AllowedAmount | 255.71 |
| Total Drug Medicare PaymentAmount | 250.6 |
| Total Drug Medicare Standardized Payment Amount | 250.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 158 |
| Number Of Medicare Beneficiaries With Medical Services | 121 |
| Total Medical Submitted Charge Amount | 21575 |
| Total Medical Medicare Allowed Amount | 9705.39 |
| Total Medical Medicare Payment Amount | 5760.01 |
| Total Medical Medicare Standardized Payment Amount | 7306.33 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 71 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 70 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9774 |