National Provider Identifier [NPI]: |
1033195847 |
Last Name Of The Provider |
POGUE |
First Name Of The Provider |
LUCAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1401 EASTLAND DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
617013514 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
2782 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
161439.5 |
Total Medicare Allowed Amount |
91535.58 |
Total Medicare Payment Amount |
73359.22 |
Total Medicare Standardized Payment Amount |
75833.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
64 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
3655 |
Total Drug Medicare AllowedAmount |
2548.39 |
Total Drug Medicare PaymentAmount |
2480.88 |
Total Drug Medicare Standardized Payment Amount |
2480.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
98 |
Number Of Medical Services |
2718 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
157784.5 |
Total Medical Medicare Allowed Amount |
88987.19 |
Total Medical Medicare Payment Amount |
70878.34 |
Total Medical Medicare Standardized Payment Amount |
73352.41 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9243 |