| National Provider Identifier [NPI]: | 1225203128 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | CORINNE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 MEDICAL VILLAGE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDGEWOOD |
| Zip Code Of The Provider | 410173403 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 794 |
| Number Of Medicare Beneficiaries | 327 |
| Total Submitted Charge Amount | 193062 |
| Total Medicare Allowed Amount | 39158.59 |
| Total Medicare Payment Amount | 30405.98 |
| Total Medicare Standardized Payment Amount | 37786.24 |
| 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 | 31 |
| Number Of Medical Services | 794 |
| Number Of Medicare Beneficiaries With Medical Services | 327 |
| Total Medical Submitted Charge Amount | 193062 |
| Total Medical Medicare Allowed Amount | 39158.59 |
| Total Medical Medicare Payment Amount | 30405.98 |
| Total Medical Medicare Standardized Payment Amount | 37786.24 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 314 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 66 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.8775 |