National Provider Identifier [NPI]: |
1861673980 |
Last Name Of The Provider |
MOZENA |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8305 SE MONTEREY |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972667728 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
826 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
146965 |
Total Medicare Allowed Amount |
51673.8 |
Total Medicare Payment Amount |
35574.38 |
Total Medicare Standardized Payment Amount |
37487.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
93 |
Number Of Medicare Beneficiaries With Drug Services |
71 |
Total Drug Submitted ChargeAmount |
1395 |
Total Drug Medicare AllowedAmount |
529.02 |
Total Drug Medicare PaymentAmount |
382.82 |
Total Drug Medicare Standardized Payment Amount |
382.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
733 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
145570 |
Total Medical Medicare Allowed Amount |
51144.78 |
Total Medical Medicare Payment Amount |
35191.56 |
Total Medical Medicare Standardized Payment Amount |
37104.53 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
191 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8839 |