| National Provider Identifier [NPI]: | 1083650287 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | NATHAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2009 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONROE |
| Zip Code Of The Provider | 535661546 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 1386 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 946094.25 |
| Total Medicare Allowed Amount | 133093.01 |
| Total Medicare Payment Amount | 98170.55 |
| Total Medicare Standardized Payment Amount | 101914.45 |
| 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 | 79 |
| Number Of Medical Services | 1386 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 946094.25 |
| Total Medical Medicare Allowed Amount | 133093.01 |
| Total Medical Medicare Payment Amount | 98170.55 |
| Total Medical Medicare Standardized Payment Amount | 101914.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 507 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1718 |