National Provider Identifier [NPI]: |
1700860996 |
Last Name Of The Provider |
MOEZZI |
First Name Of The Provider |
DARIUS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 W FOREST AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
FLAGSTAFF |
Zip Code Of The Provider |
860011479 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
3400 |
Number Of Medicare Beneficiaries |
411 |
Total Submitted Charge Amount |
1094502.87 |
Total Medicare Allowed Amount |
253408.87 |
Total Medicare Payment Amount |
190887.89 |
Total Medicare Standardized Payment Amount |
188566.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1328 |
Number Of Medicare Beneficiaries With Drug Services |
107 |
Total Drug Submitted ChargeAmount |
37718.8 |
Total Drug Medicare AllowedAmount |
14027.26 |
Total Drug Medicare PaymentAmount |
10825.05 |
Total Drug Medicare Standardized Payment Amount |
10825.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
2072 |
Number Of Medicare Beneficiaries With Medical Services |
411 |
Total Medical Submitted Charge Amount |
1056784.07 |
Total Medical Medicare Allowed Amount |
239381.61 |
Total Medical Medicare Payment Amount |
180062.84 |
Total Medical Medicare Standardized Payment Amount |
177741.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
306 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
65 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0316 |