National Provider Identifier [NPI]: |
1396937884 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
SHAWNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24 HOSPITAL AVE |
Street Address 2 Of The Provider |
DOPS/PULMONARY |
City Of The Provider |
DANBURY |
Zip Code Of The Provider |
068106099 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
2279 |
Number Of Medicare Beneficiaries |
223 |
Total Submitted Charge Amount |
201097 |
Total Medicare Allowed Amount |
87059.45 |
Total Medicare Payment Amount |
68244.08 |
Total Medicare Standardized Payment Amount |
70173.53 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
204 |
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 |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
68 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
75 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.4842 |