| National Provider Identifier [NPI]: | 1770553174 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | LARRY |
| 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 | 5308 NORTH GALLOWAY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MESQUITE |
| Zip Code Of The Provider | 75150 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 3436 |
| Number Of Medicare Beneficiaries | 1247 |
| Total Submitted Charge Amount | 435372 |
| Total Medicare Allowed Amount | 208552.38 |
| Total Medicare Payment Amount | 156021.89 |
| Total Medicare Standardized Payment Amount | 156466.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 216 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 11880 |
| Total Drug Medicare AllowedAmount | 11446.03 |
| Total Drug Medicare PaymentAmount | 8641.75 |
| Total Drug Medicare Standardized Payment Amount | 8641.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 3220 |
| Number Of Medicare Beneficiaries With Medical Services | 1247 |
| Total Medical Submitted Charge Amount | 423492 |
| Total Medical Medicare Allowed Amount | 197106.35 |
| Total Medical Medicare Payment Amount | 147380.14 |
| Total Medical Medicare Standardized Payment Amount | 147824.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 274 |
| Number Of Beneficiaries Age 65 to 74 | 433 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 192 |
| Number Of Female Beneficiaries | 753 |
| Number Of Male Beneficiaries | 494 |
| Number Of Non Hispanic White Beneficiaries | 891 |
| Number Of Black or African American Beneficiaries | 236 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 100 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 468 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.1315 |