| National Provider Identifier [NPI]: | 1891752283 |
| Last Name Of The Provider | LUCERO |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18444 N 25TH AVE |
| Street Address 2 Of The Provider | STE 210 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850231264 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 1707 |
| Number Of Medicare Beneficiaries | 213 |
| Total Submitted Charge Amount | 252151.36 |
| Total Medicare Allowed Amount | 100564.29 |
| Total Medicare Payment Amount | 77191.95 |
| Total Medicare Standardized Payment Amount | 77328.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 818 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 12788.22 |
| Total Drug Medicare AllowedAmount | 5294.13 |
| Total Drug Medicare PaymentAmount | 4022 |
| Total Drug Medicare Standardized Payment Amount | 4022 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 889 |
| Number Of Medicare Beneficiaries With Medical Services | 213 |
| Total Medical Submitted Charge Amount | 239363.14 |
| Total Medical Medicare Allowed Amount | 95270.16 |
| Total Medical Medicare Payment Amount | 73169.95 |
| Total Medical Medicare Standardized Payment Amount | 73306.25 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 182 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3513 |