National Provider Identifier [NPI]: |
1730287004 |
Last Name Of The Provider |
LUKER |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1103 COLLEGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MENA |
Zip Code Of The Provider |
719532519 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
285 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
21261 |
Total Medicare Allowed Amount |
12663.65 |
Total Medicare Payment Amount |
8976.94 |
Total Medicare Standardized Payment Amount |
9978.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
82 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
494 |
Total Drug Medicare AllowedAmount |
201.3 |
Total Drug Medicare PaymentAmount |
166.28 |
Total Drug Medicare Standardized Payment Amount |
166.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
203 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
20767 |
Total Medical Medicare Allowed Amount |
12462.35 |
Total Medical Medicare Payment Amount |
8810.66 |
Total Medical Medicare Standardized Payment Amount |
9812.58 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
43 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
23 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8174 |