| National Provider Identifier [NPI]: | 1275512360 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | CHARLOTTE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1405 KILN CREEK PARKWAY |
| Street Address 2 Of The Provider | STE K |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 23602 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 2493 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 204275 |
| Total Medicare Allowed Amount | 86632.83 |
| Total Medicare Payment Amount | 67842.71 |
| Total Medicare Standardized Payment Amount | 69813.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 135 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 7108 |
| Total Drug Medicare AllowedAmount | 4046.03 |
| Total Drug Medicare PaymentAmount | 3950.4 |
| Total Drug Medicare Standardized Payment Amount | 3950.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2358 |
| Number Of Medicare Beneficiaries With Medical Services | 140 |
| Total Medical Submitted Charge Amount | 197167 |
| Total Medical Medicare Allowed Amount | 82586.8 |
| Total Medical Medicare Payment Amount | 63892.31 |
| Total Medical Medicare Standardized Payment Amount | 65863.53 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 112 |
| 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 | 129 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8248 |