National Provider Identifier [NPI]: |
1942349220 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
VICKI |
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 |
7191 CAHABA VALLEY RD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352426402 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
1145 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
69072.5 |
Total Medicare Allowed Amount |
55429.29 |
Total Medicare Payment Amount |
39141.22 |
Total Medicare Standardized Payment Amount |
43318.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
288 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
3853 |
Total Drug Medicare AllowedAmount |
1439.36 |
Total Drug Medicare PaymentAmount |
1311.46 |
Total Drug Medicare Standardized Payment Amount |
1311.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
857 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
65219.5 |
Total Medical Medicare Allowed Amount |
53989.93 |
Total Medical Medicare Payment Amount |
37829.76 |
Total Medical Medicare Standardized Payment Amount |
42006.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
201 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
5 |
Percent Of With Chronic Kidney Disease |
6 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7468 |