National Provider Identifier [NPI]: |
1679576789 |
Last Name Of The Provider |
LOMAN |
First Name Of The Provider |
CHRIS |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 W RAMPART ST |
Street Address 2 Of The Provider |
STE 210 |
City Of The Provider |
SHELBYVILLE |
Zip Code Of The Provider |
461768897 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
2733 |
Number Of Medicare Beneficiaries |
853 |
Total Submitted Charge Amount |
590987 |
Total Medicare Allowed Amount |
192621.79 |
Total Medicare Payment Amount |
136599.6 |
Total Medicare Standardized Payment Amount |
144340.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
540 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
17720 |
Total Drug Medicare AllowedAmount |
7073.19 |
Total Drug Medicare PaymentAmount |
6606.05 |
Total Drug Medicare Standardized Payment Amount |
6606.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
2193 |
Number Of Medicare Beneficiaries With Medical Services |
853 |
Total Medical Submitted Charge Amount |
573267 |
Total Medical Medicare Allowed Amount |
185548.6 |
Total Medical Medicare Payment Amount |
129993.55 |
Total Medical Medicare Standardized Payment Amount |
137734.89 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
286 |
Number Of Beneficiaries Age 75 to 84 |
274 |
Number Of Beneficiaries Age Greater 84 |
190 |
Number Of Female Beneficiaries |
520 |
Number Of Male Beneficiaries |
333 |
Number Of Non Hispanic White Beneficiaries |
834 |
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 |
628 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3983 |