National Provider Identifier [NPI]: |
1891731063 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 LANTERN BEND |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770902639 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1659 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
231451.52 |
Total Medicare Allowed Amount |
88527.81 |
Total Medicare Payment Amount |
65236.85 |
Total Medicare Standardized Payment Amount |
65876.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
469 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
2345 |
Total Drug Medicare AllowedAmount |
829.42 |
Total Drug Medicare PaymentAmount |
635.95 |
Total Drug Medicare Standardized Payment Amount |
635.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1190 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
229106.52 |
Total Medical Medicare Allowed Amount |
87698.39 |
Total Medical Medicare Payment Amount |
64600.9 |
Total Medical Medicare Standardized Payment Amount |
65241.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
24 |
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 |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4131 |