| National Provider Identifier [NPI]: | 1114188687 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | ERIN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 904 7TH AVE |
| Street Address 2 Of The Provider | POLYCLINIC DERMATOLOGY 6TH FLOOR |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981041132 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1739 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 321448.64 |
| Total Medicare Allowed Amount | 120404.3 |
| Total Medicare Payment Amount | 86295.57 |
| Total Medicare Standardized Payment Amount | 78921.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 44.64 |
| Total Drug Medicare AllowedAmount | 28.62 |
| Total Drug Medicare PaymentAmount | 19.58 |
| Total Drug Medicare Standardized Payment Amount | 19.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 1723 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 321404 |
| Total Medical Medicare Allowed Amount | 120375.68 |
| Total Medical Medicare Payment Amount | 86275.99 |
| Total Medical Medicare Standardized Payment Amount | 78901.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 288 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| 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 | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2358 |