National Provider Identifier [NPI]: |
1235142266 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
ANGELA |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD, PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
711 E LAMAR BLVD STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760113800 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
13922 |
Number Of Medicare Beneficiaries |
882 |
Total Submitted Charge Amount |
812754.4 |
Total Medicare Allowed Amount |
753612.72 |
Total Medicare Payment Amount |
555080.06 |
Total Medicare Standardized Payment Amount |
564236.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
254 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
10558.24 |
Total Drug Medicare AllowedAmount |
8851.66 |
Total Drug Medicare PaymentAmount |
6644.43 |
Total Drug Medicare Standardized Payment Amount |
6644.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
13668 |
Number Of Medicare Beneficiaries With Medical Services |
882 |
Total Medical Submitted Charge Amount |
802196.16 |
Total Medical Medicare Allowed Amount |
744761.06 |
Total Medical Medicare Payment Amount |
548435.63 |
Total Medical Medicare Standardized Payment Amount |
557592.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
509 |
Number Of Beneficiaries Age 75 to 84 |
223 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
494 |
Number Of Male Beneficiaries |
388 |
Number Of Non Hispanic White Beneficiaries |
761 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
794 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0017 |