| National Provider Identifier [NPI]: | 1912943838 |
| Last Name Of The Provider | LUCKEY |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 336 S 9TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAVID CITY |
| Zip Code Of The Provider | 686322116 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 218 |
| Number Of Services | 9229 |
| Number Of Medicare Beneficiaries | 773 |
| Total Submitted Charge Amount | 817574.8 |
| Total Medicare Allowed Amount | 356517.65 |
| Total Medicare Payment Amount | 257374.81 |
| Total Medicare Standardized Payment Amount | 281031.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 26 |
| Number Of Drug Services | 1637 |
| Number Of Medicare Beneficiaries With Drug Services | 450 |
| Total Drug Submitted ChargeAmount | 32118 |
| Total Drug Medicare AllowedAmount | 19874.1 |
| Total Drug Medicare PaymentAmount | 17261.34 |
| Total Drug Medicare Standardized Payment Amount | 17261.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 192 |
| Number Of Medical Services | 7592 |
| Number Of Medicare Beneficiaries With Medical Services | 772 |
| Total Medical Submitted Charge Amount | 785456.8 |
| Total Medical Medicare Allowed Amount | 336643.55 |
| Total Medical Medicare Payment Amount | 240113.47 |
| Total Medical Medicare Standardized Payment Amount | 263770.33 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 274 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 196 |
| Number Of Female Beneficiaries | 463 |
| Number Of Male Beneficiaries | 310 |
| 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 | 663 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0242 |