National Provider Identifier [NPI]: |
1558523076 |
Last Name Of The Provider |
MOORE |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 RAINBOW |
Street Address 2 Of The Provider |
MS 1020, DIVISION OF GENERAL & GERIATRIC MEDICINE |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
66160 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
162 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
74511 |
Total Medicare Allowed Amount |
28187.43 |
Total Medicare Payment Amount |
21621.61 |
Total Medicare Standardized Payment Amount |
22715.31 |
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 |
11 |
Number Of Medical Services |
162 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
74511 |
Total Medical Medicare Allowed Amount |
28187.43 |
Total Medical Medicare Payment Amount |
21621.61 |
Total Medical Medicare Standardized Payment Amount |
22715.31 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
35 |
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 |
69 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.8725 |