| National Provider Identifier [NPI]: | 1659354900 |
| Last Name Of The Provider | LOUGH |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 WENONAH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEARISBURG |
| Zip Code Of The Provider | 241341839 |
| 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 | 54 |
| Number Of Services | 429 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 53197 |
| Total Medicare Allowed Amount | 25214.53 |
| Total Medicare Payment Amount | 18029.42 |
| Total Medicare Standardized Payment Amount | 18735.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 880 |
| Total Drug Medicare AllowedAmount | 368.46 |
| Total Drug Medicare PaymentAmount | 304.95 |
| Total Drug Medicare Standardized Payment Amount | 304.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 386 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 52317 |
| Total Medical Medicare Allowed Amount | 24846.07 |
| Total Medical Medicare Payment Amount | 17724.47 |
| Total Medical Medicare Standardized Payment Amount | 18430.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 145 |
| Number Of Male Beneficiaries | 75 |
| 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 | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8826 |