| National Provider Identifier [NPI]: | 1629064613 |
| Last Name Of The Provider | LONQUIST |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13555 W MCDOWELL RD |
| Street Address 2 Of The Provider | #103 |
| City Of The Provider | GOODYEAR |
| Zip Code Of The Provider | 85395 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1904 |
| Number Of Medicare Beneficiaries | 414 |
| Total Submitted Charge Amount | 156563.1 |
| Total Medicare Allowed Amount | 102895.4 |
| Total Medicare Payment Amount | 71807.49 |
| Total Medicare Standardized Payment Amount | 74790.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 393 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 9587.1 |
| Total Drug Medicare AllowedAmount | 3733.6 |
| Total Drug Medicare PaymentAmount | 3347.69 |
| Total Drug Medicare Standardized Payment Amount | 3347.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1511 |
| Number Of Medicare Beneficiaries With Medical Services | 414 |
| Total Medical Submitted Charge Amount | 146976 |
| Total Medical Medicare Allowed Amount | 99161.8 |
| Total Medical Medicare Payment Amount | 68459.8 |
| Total Medical Medicare Standardized Payment Amount | 71442.72 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 189 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 357 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9646 |