National Provider Identifier [NPI]: |
1043221443 |
Last Name Of The Provider |
MOON |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1256 S JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRANKFORT |
Zip Code Of The Provider |
460413311 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
3173 |
Number Of Medicare Beneficiaries |
700 |
Total Submitted Charge Amount |
338205 |
Total Medicare Allowed Amount |
164381.91 |
Total Medicare Payment Amount |
113254.42 |
Total Medicare Standardized Payment Amount |
123435.81 |
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 |
51 |
Number Of Medical Services |
3173 |
Number Of Medicare Beneficiaries With Medical Services |
700 |
Total Medical Submitted Charge Amount |
338205 |
Total Medical Medicare Allowed Amount |
164381.91 |
Total Medical Medicare Payment Amount |
113254.42 |
Total Medical Medicare Standardized Payment Amount |
123435.81 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
426 |
Number Of Male Beneficiaries |
274 |
Number Of Non Hispanic White Beneficiaries |
678 |
Number Of Black or African American Beneficiaries |
|
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 |
554 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4391 |