| National Provider Identifier [NPI]: | 1427366376 |
| Last Name Of The Provider | LUCAS |
| First Name Of The Provider | TARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | A.P.N. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 834 N SEMINARY ST |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | GALESBURG |
| Zip Code Of The Provider | 614012852 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 6997 |
| Number Of Medicare Beneficiaries | 711 |
| Total Submitted Charge Amount | 568361 |
| Total Medicare Allowed Amount | 170981.86 |
| Total Medicare Payment Amount | 127238.58 |
| Total Medicare Standardized Payment Amount | 146221.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 2322 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 90748 |
| Total Drug Medicare AllowedAmount | 28811.86 |
| Total Drug Medicare PaymentAmount | 22589.15 |
| Total Drug Medicare Standardized Payment Amount | 22589.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 4675 |
| Number Of Medicare Beneficiaries With Medical Services | 711 |
| Total Medical Submitted Charge Amount | 477613 |
| Total Medical Medicare Allowed Amount | 142170 |
| Total Medical Medicare Payment Amount | 104649.43 |
| Total Medical Medicare Standardized Payment Amount | 123632.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 456 |
| Number Of Non Hispanic White Beneficiaries | 678 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 606 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1617 |