| National Provider Identifier [NPI]: | 1922078146 |
| Last Name Of The Provider | MOORE-FARRELL |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2322 SOUTH 57 STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 72903 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 13001 |
| Number Of Medicare Beneficiaries | 6485 |
| Total Submitted Charge Amount | 1059421.5 |
| Total Medicare Allowed Amount | 289765.26 |
| Total Medicare Payment Amount | 231615.14 |
| Total Medicare Standardized Payment Amount | 249819.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1160 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 2742.5 |
| Total Drug Medicare AllowedAmount | 330.46 |
| Total Drug Medicare PaymentAmount | 257.57 |
| Total Drug Medicare Standardized Payment Amount | 257.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 11841 |
| Number Of Medicare Beneficiaries With Medical Services | 6485 |
| Total Medical Submitted Charge Amount | 1056679 |
| Total Medical Medicare Allowed Amount | 289434.8 |
| Total Medical Medicare Payment Amount | 231357.57 |
| Total Medical Medicare Standardized Payment Amount | 249561.85 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1152 |
| Number Of Beneficiaries Age 65 to 74 | 2662 |
| Number Of Beneficiaries Age 75 to 84 | 1922 |
| Number Of Beneficiaries Age Greater 84 | 749 |
| Number Of Female Beneficiaries | 4349 |
| Number Of Male Beneficiaries | 2136 |
| Number Of Non Hispanic White Beneficiaries | 6011 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | 164 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5009 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1476 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2731 |