| National Provider Identifier [NPI]: | 1457351710 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | BECKIE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | CS FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 S US HIGHWAY 169 |
| Street Address 2 Of The Provider | ATTN: ER |
| City Of The Provider | SMITHVILLE |
| Zip Code Of The Provider | 640899317 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 474 |
| Number Of Medicare Beneficiaries | 100 |
| Total Submitted Charge Amount | 32902.38 |
| Total Medicare Allowed Amount | 21521.3 |
| Total Medicare Payment Amount | 13551.96 |
| Total Medicare Standardized Payment Amount | 17005.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 231 |
| Total Drug Medicare AllowedAmount | 115.89 |
| Total Drug Medicare PaymentAmount | 103.04 |
| Total Drug Medicare Standardized Payment Amount | 103.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 450 |
| Number Of Medicare Beneficiaries With Medical Services | 100 |
| Total Medical Submitted Charge Amount | 32671.38 |
| Total Medical Medicare Allowed Amount | 21405.41 |
| Total Medical Medicare Payment Amount | 13448.92 |
| Total Medical Medicare Standardized Payment Amount | 16902.73 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 84 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8473 |