| National Provider Identifier [NPI]: | 1588678841 |
| Last Name Of The Provider | LUCIDI |
| First Name Of The Provider | EDGAR |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 328 HAZEL DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORONA DEL MAR |
| Zip Code Of The Provider | 926253031 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 8763 |
| Number Of Medicare Beneficiaries | 2388 |
| Total Submitted Charge Amount | 722209.77 |
| Total Medicare Allowed Amount | 463723.29 |
| Total Medicare Payment Amount | 360178.49 |
| Total Medicare Standardized Payment Amount | 275004.3 |
| 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 | 11 |
| Number Of Medical Services | 8763 |
| Number Of Medicare Beneficiaries With Medical Services | 2388 |
| Total Medical Submitted Charge Amount | 722209.77 |
| Total Medical Medicare Allowed Amount | 463723.29 |
| Total Medical Medicare Payment Amount | 360178.49 |
| Total Medical Medicare Standardized Payment Amount | 275004.3 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 337 |
| Number Of Beneficiaries Age 65 to 74 | 504 |
| Number Of Beneficiaries Age 75 to 84 | 661 |
| Number Of Beneficiaries Age Greater 84 | 886 |
| Number Of Female Beneficiaries | 1414 |
| Number Of Male Beneficiaries | 974 |
| Number Of Non Hispanic White Beneficiaries | 807 |
| Number Of Black or African American Beneficiaries | 292 |
| Number Of AsianPacific Islander Beneficiaries | 558 |
| Number Of Hispanic Beneficiaries | 694 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2233 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 72 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 44 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 3.3132 |