| National Provider Identifier [NPI]: | 1730149741 |
| Last Name Of The Provider | MOODY |
| First Name Of The Provider | LACKEY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 WHITE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BATESVILLE |
| Zip Code Of The Provider | 725019467 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 7376 |
| Number Of Medicare Beneficiaries | 445 |
| Total Submitted Charge Amount | 349422.25 |
| Total Medicare Allowed Amount | 249514.51 |
| Total Medicare Payment Amount | 182439.85 |
| Total Medicare Standardized Payment Amount | 200141.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 1126 |
| Number Of Medicare Beneficiaries With Drug Services | 242 |
| Total Drug Submitted ChargeAmount | 19732.25 |
| Total Drug Medicare AllowedAmount | 15039.53 |
| Total Drug Medicare PaymentAmount | 13114.76 |
| Total Drug Medicare Standardized Payment Amount | 13114.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 6250 |
| Number Of Medicare Beneficiaries With Medical Services | 445 |
| Total Medical Submitted Charge Amount | 329690 |
| Total Medical Medicare Allowed Amount | 234474.98 |
| Total Medical Medicare Payment Amount | 169325.09 |
| Total Medical Medicare Standardized Payment Amount | 187026.54 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 209 |
| 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 | 308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9063 |