National Provider Identifier [NPI]: |
1669419776 |
Last Name Of The Provider |
MOFFITT |
First Name Of The Provider |
HARRY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7905 CALUMET AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212549 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
5530 |
Number Of Medicare Beneficiaries |
515 |
Total Submitted Charge Amount |
1277658.07 |
Total Medicare Allowed Amount |
340874.57 |
Total Medicare Payment Amount |
253633.59 |
Total Medicare Standardized Payment Amount |
276692.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3364 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
78908.72 |
Total Drug Medicare AllowedAmount |
44912.54 |
Total Drug Medicare PaymentAmount |
34887.53 |
Total Drug Medicare Standardized Payment Amount |
34887.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
2166 |
Number Of Medicare Beneficiaries With Medical Services |
515 |
Total Medical Submitted Charge Amount |
1198749.35 |
Total Medical Medicare Allowed Amount |
295962.03 |
Total Medical Medicare Payment Amount |
218746.06 |
Total Medical Medicare Standardized Payment Amount |
241805.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
418 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
474 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9889 |