| National Provider Identifier [NPI]: | 1407848617 |
| Last Name Of The Provider | LUECKING |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1790 NATIONS DR |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | GURNEE |
| Zip Code Of The Provider | 600319164 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 850 |
| Number Of Medicare Beneficiaries | 123 |
| Total Submitted Charge Amount | 55711 |
| Total Medicare Allowed Amount | 32962.03 |
| Total Medicare Payment Amount | 22618.81 |
| Total Medicare Standardized Payment Amount | 21720.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 323 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 904 |
| Total Drug Medicare AllowedAmount | 305.42 |
| Total Drug Medicare PaymentAmount | 277.37 |
| Total Drug Medicare Standardized Payment Amount | 277.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 527 |
| Number Of Medicare Beneficiaries With Medical Services | 123 |
| Total Medical Submitted Charge Amount | 54807 |
| Total Medical Medicare Allowed Amount | 32656.61 |
| Total Medical Medicare Payment Amount | 22341.44 |
| Total Medical Medicare Standardized Payment Amount | 21443 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | 97 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 86 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9372 |