| National Provider Identifier [NPI]: | 1053461715 |
| Last Name Of The Provider | LACY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 DANIEL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 404222527 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 1679 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 465529.86 |
| Total Medicare Allowed Amount | 199941.27 |
| Total Medicare Payment Amount | 152235.47 |
| Total Medicare Standardized Payment Amount | 161631.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 1679 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 465529.86 |
| Total Medical Medicare Allowed Amount | 199941.27 |
| Total Medical Medicare Payment Amount | 152235.47 |
| Total Medical Medicare Standardized Payment Amount | 161631.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 222 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 417 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 691 |
| 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 | 460 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5825 |