| National Provider Identifier [NPI]: | 1255322343 |
| Last Name Of The Provider | LUSTIG |
| First Name Of The Provider | MICHAEL |
| 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 | 10510 JEFFERSON AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236013102 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 890 |
| Number Of Medicare Beneficiaries | 354 |
| Total Submitted Charge Amount | 82541 |
| Total Medicare Allowed Amount | 50041 |
| Total Medicare Payment Amount | 34966.57 |
| Total Medicare Standardized Payment Amount | 35893.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 951 |
| Total Drug Medicare AllowedAmount | 501.42 |
| Total Drug Medicare PaymentAmount | 491.06 |
| Total Drug Medicare Standardized Payment Amount | 491.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 864 |
| Number Of Medicare Beneficiaries With Medical Services | 354 |
| Total Medical Submitted Charge Amount | 81590 |
| Total Medical Medicare Allowed Amount | 49539.58 |
| Total Medical Medicare Payment Amount | 34475.51 |
| Total Medical Medicare Standardized Payment Amount | 35402.54 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 105 |
| Number Of Black or African American Beneficiaries | 234 |
| 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 | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 228 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4175 |