| National Provider Identifier [NPI]: | 1134266190 |
| Last Name Of The Provider | LOUCK |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 118 W DREXEL PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | RENSSELAER |
| Zip Code Of The Provider | 479787344 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3389.5 |
| Number Of Medicare Beneficiaries | 828 |
| Total Submitted Charge Amount | 473260 |
| Total Medicare Allowed Amount | 228568.53 |
| Total Medicare Payment Amount | 165068.25 |
| Total Medicare Standardized Payment Amount | 169048.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 406.5 |
| Number Of Medicare Beneficiaries With Drug Services | 259 |
| Total Drug Submitted ChargeAmount | 22103 |
| Total Drug Medicare AllowedAmount | 9387.7 |
| Total Drug Medicare PaymentAmount | 8980.69 |
| Total Drug Medicare Standardized Payment Amount | 8980.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 2983 |
| Number Of Medicare Beneficiaries With Medical Services | 828 |
| Total Medical Submitted Charge Amount | 451157 |
| Total Medical Medicare Allowed Amount | 219180.83 |
| Total Medical Medicare Payment Amount | 156087.56 |
| Total Medical Medicare Standardized Payment Amount | 160067.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 310 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 193 |
| Number Of Female Beneficiaries | 495 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 810 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 689 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0238 |