National Provider Identifier [NPI]: |
1821259102 |
Last Name Of The Provider |
MOON |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 NW 17TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI |
Zip Code Of The Provider |
331361119 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1172 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
457863 |
Total Medicare Allowed Amount |
163815.98 |
Total Medicare Payment Amount |
119208.84 |
Total Medicare Standardized Payment Amount |
110633.27 |
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 |
46 |
Number Of Medical Services |
1172 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
457863 |
Total Medical Medicare Allowed Amount |
163815.98 |
Total Medical Medicare Payment Amount |
119208.84 |
Total Medical Medicare Standardized Payment Amount |
110633.27 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
190 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5957 |