National Provider Identifier [NPI]: |
1225171929 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
MELITA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4860 Y ST |
Street Address 2 Of The Provider |
SUITE 3800 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958172307 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
3424 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
252181.6 |
Total Medicare Allowed Amount |
107218.89 |
Total Medicare Payment Amount |
80688.64 |
Total Medicare Standardized Payment Amount |
79502.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
2604 |
Number Of Medicare Beneficiaries With Drug Services |
188 |
Total Drug Submitted ChargeAmount |
104205.6 |
Total Drug Medicare AllowedAmount |
47046.6 |
Total Drug Medicare PaymentAmount |
36501.17 |
Total Drug Medicare Standardized Payment Amount |
36501.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
820 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
147976 |
Total Medical Medicare Allowed Amount |
60172.29 |
Total Medical Medicare Payment Amount |
44187.47 |
Total Medical Medicare Standardized Payment Amount |
43001.04 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1208 |