| National Provider Identifier [NPI]: | 1609904150 |
| Last Name Of The Provider | MOOTOO |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7503 ATLANTIC AVE STE D |
| Street Address 2 Of The Provider | |
| City Of The Provider | CUDAHY |
| Zip Code Of The Provider | 902016805 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2810 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 498851.81 |
| Total Medicare Allowed Amount | 374161.39 |
| Total Medicare Payment Amount | 281408.7 |
| Total Medicare Standardized Payment Amount | 265593.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 7717 |
| Total Drug Medicare AllowedAmount | 255.68 |
| Total Drug Medicare PaymentAmount | 245.01 |
| Total Drug Medicare Standardized Payment Amount | 245.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2765 |
| Number Of Medicare Beneficiaries With Medical Services | 324 |
| Total Medical Submitted Charge Amount | 491134.81 |
| Total Medical Medicare Allowed Amount | 373905.71 |
| Total Medical Medicare Payment Amount | 281163.69 |
| Total Medical Medicare Standardized Payment Amount | 265348.46 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 228 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 294 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 72 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 73 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 4.008 |