National Provider Identifier [NPI]: |
1003847443 |
Last Name Of The Provider |
MOORE-SCOTT |
First Name Of The Provider |
JINEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
657 E 24TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKLYN |
Zip Code Of The Provider |
112101131 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
638 |
Number Of Medicare Beneficiaries |
328 |
Total Submitted Charge Amount |
34912 |
Total Medicare Allowed Amount |
13239.1 |
Total Medicare Payment Amount |
8551.03 |
Total Medicare Standardized Payment Amount |
7634.39 |
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 |
60 |
Number Of Medical Services |
638 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
34912 |
Total Medical Medicare Allowed Amount |
13239.1 |
Total Medical Medicare Payment Amount |
8551.03 |
Total Medical Medicare Standardized Payment Amount |
7634.39 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
124 |
Number Of Black or African American Beneficiaries |
115 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
78 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
192 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2772 |