National Provider Identifier [NPI]: |
1588831127 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 MILL ROAD, SUITE 180 |
Street Address 2 Of The Provider |
SOUTHCOAST PHYSICIANS GROUP |
City Of The Provider |
FAIRHAVEN |
Zip Code Of The Provider |
02719 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
334 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
90254 |
Total Medicare Allowed Amount |
37624.56 |
Total Medicare Payment Amount |
28788.17 |
Total Medicare Standardized Payment Amount |
29198.44 |
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 |
9 |
Number Of Medical Services |
334 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
90254 |
Total Medical Medicare Allowed Amount |
37624.56 |
Total Medical Medicare Payment Amount |
28788.17 |
Total Medical Medicare Standardized Payment Amount |
29198.44 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
134 |
Number Of Black or African American Beneficiaries |
|
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 |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9451 |