| National Provider Identifier [NPI]: | 1902872203 |
| Last Name Of The Provider | MOONEY |
| First Name Of The Provider | MARTHA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 GRESHAM DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235071904 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 1118 |
| Number Of Medicare Beneficiaries | 144 |
| Total Submitted Charge Amount | 174255 |
| Total Medicare Allowed Amount | 94769.04 |
| Total Medicare Payment Amount | 74110 |
| Total Medicare Standardized Payment Amount | 75481.64 |
| 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 | 7 |
| Number Of Medical Services | 1118 |
| Number Of Medicare Beneficiaries With Medical Services | 144 |
| Total Medical Submitted Charge Amount | 174255 |
| Total Medical Medicare Allowed Amount | 94769.04 |
| Total Medical Medicare Payment Amount | 74110 |
| Total Medical Medicare Standardized Payment Amount | 75481.64 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 48 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 100 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 69 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 4.0946 |