| National Provider Identifier [NPI]: | 1639162795 |
| Last Name Of The Provider | MOY |
| First Name Of The Provider | MANNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6542 SE LAKE RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | MILWAUKIE |
| Zip Code Of The Provider | 972222138 |
| 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 | 66 |
| Number Of Services | 2364 |
| Number Of Medicare Beneficiaries | 412 |
| Total Submitted Charge Amount | 371155.02 |
| Total Medicare Allowed Amount | 165571.88 |
| Total Medicare Payment Amount | 119308.88 |
| Total Medicare Standardized Payment Amount | 120682.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 308 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 26582 |
| Total Drug Medicare AllowedAmount | 11679.6 |
| Total Drug Medicare PaymentAmount | 9041.58 |
| Total Drug Medicare Standardized Payment Amount | 9041.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 2056 |
| Number Of Medicare Beneficiaries With Medical Services | 412 |
| Total Medical Submitted Charge Amount | 344573.02 |
| Total Medical Medicare Allowed Amount | 153892.28 |
| Total Medical Medicare Payment Amount | 110267.3 |
| Total Medical Medicare Standardized Payment Amount | 111640.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 233 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 313 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7559 |