National Provider Identifier [NPI]: |
1154585388 |
Last Name Of The Provider |
MOON |
First Name Of The Provider |
CYRUS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
432 LEXINGTON ST |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
DELANO |
Zip Code Of The Provider |
93215 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
673 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
309371 |
Total Medicare Allowed Amount |
131893.59 |
Total Medicare Payment Amount |
102692.85 |
Total Medicare Standardized Payment Amount |
101529.48 |
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 |
109 |
Number Of Medical Services |
673 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
309371 |
Total Medical Medicare Allowed Amount |
131893.59 |
Total Medical Medicare Payment Amount |
102692.85 |
Total Medical Medicare Standardized Payment Amount |
101529.48 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
44 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
135 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3279 |