| National Provider Identifier [NPI]: | 1306882139 |
| Last Name Of The Provider | MORENO |
| First Name Of The Provider | BRIDGET |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 GARNER FIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | UVALDE |
| Zip Code Of The Provider | 788014809 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 653 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 94235 |
| Total Medicare Allowed Amount | 34880.5 |
| Total Medicare Payment Amount | 26631.6 |
| Total Medicare Standardized Payment Amount | 32428.51 |
| 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 | 25 |
| Number Of Medical Services | 653 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 94235 |
| Total Medical Medicare Allowed Amount | 34880.5 |
| Total Medical Medicare Payment Amount | 26631.6 |
| Total Medical Medicare Standardized Payment Amount | 32428.51 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 126 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 141 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 53 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 73 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9082 |