National Provider Identifier [NPI]: |
1124055447 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
235 N PEARL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROCKTON |
Zip Code Of The Provider |
023011794 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
588 |
Number Of Medicare Beneficiaries |
524 |
Total Submitted Charge Amount |
276144 |
Total Medicare Allowed Amount |
106439.27 |
Total Medicare Payment Amount |
81960.39 |
Total Medicare Standardized Payment Amount |
81010.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
588 |
Number Of Medicare Beneficiaries With Medical Services |
524 |
Total Medical Submitted Charge Amount |
276144 |
Total Medical Medicare Allowed Amount |
106439.27 |
Total Medical Medicare Payment Amount |
81960.39 |
Total Medical Medicare Standardized Payment Amount |
81010.6 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
475 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
276 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
248 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1753 |