| National Provider Identifier [NPI]: | 1376525501 |
| Last Name Of The Provider | LUSTGARTEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 834 E OCEAN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349942428 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 6192 |
| Number Of Medicare Beneficiaries | 1217 |
| Total Submitted Charge Amount | 657330 |
| Total Medicare Allowed Amount | 448078.44 |
| Total Medicare Payment Amount | 328848.96 |
| Total Medicare Standardized Payment Amount | 321909.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 641 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 130220 |
| Total Drug Medicare AllowedAmount | 78160 |
| Total Drug Medicare PaymentAmount | 58954.53 |
| Total Drug Medicare Standardized Payment Amount | 58954.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 5551 |
| Number Of Medicare Beneficiaries With Medical Services | 1217 |
| Total Medical Submitted Charge Amount | 527110 |
| Total Medical Medicare Allowed Amount | 369918.44 |
| Total Medical Medicare Payment Amount | 269894.43 |
| Total Medical Medicare Standardized Payment Amount | 262954.63 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 502 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 1065 |
| Number Of Non Hispanic White Beneficiaries | 1145 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1691 |