National Provider Identifier [NPI]: |
1992776066 |
Last Name Of The Provider |
LOGUE |
First Name Of The Provider |
LLOYD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
527 N PALO ALTO AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PANAMA CITY |
Zip Code Of The Provider |
324013639 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
188 |
Number Of Services |
7594 |
Number Of Medicare Beneficiaries |
4460 |
Total Submitted Charge Amount |
750702 |
Total Medicare Allowed Amount |
256603.54 |
Total Medicare Payment Amount |
200423.61 |
Total Medicare Standardized Payment Amount |
202750.15 |
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 |
188 |
Number Of Medical Services |
7594 |
Number Of Medicare Beneficiaries With Medical Services |
4460 |
Total Medical Submitted Charge Amount |
750702 |
Total Medical Medicare Allowed Amount |
256603.54 |
Total Medical Medicare Payment Amount |
200423.61 |
Total Medical Medicare Standardized Payment Amount |
202750.15 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
895 |
Number Of Beneficiaries Age 65 to 74 |
1595 |
Number Of Beneficiaries Age 75 to 84 |
1351 |
Number Of Beneficiaries Age Greater 84 |
619 |
Number Of Female Beneficiaries |
2631 |
Number Of Male Beneficiaries |
1829 |
Number Of Non Hispanic White Beneficiaries |
3938 |
Number Of Black or African American Beneficiaries |
390 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
43 |
Number Of Beneficiaries With Medicare Only Entitlement |
3164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1296 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7121 |