National Provider Identifier [NPI]: |
1285675975 |
Last Name Of The Provider |
MOSCOW |
First Name Of The Provider |
NORMAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2125 OAK GROVE RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
WALNUT CREEK |
Zip Code Of The Provider |
945982536 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
114 |
Number Of Services |
4574 |
Number Of Medicare Beneficiaries |
2103 |
Total Submitted Charge Amount |
415369 |
Total Medicare Allowed Amount |
88319.37 |
Total Medicare Payment Amount |
68681.77 |
Total Medicare Standardized Payment Amount |
63424.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
1200 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
1200 |
Total Drug Medicare AllowedAmount |
244.81 |
Total Drug Medicare PaymentAmount |
191.94 |
Total Drug Medicare Standardized Payment Amount |
191.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
113 |
Number Of Medical Services |
3374 |
Number Of Medicare Beneficiaries With Medical Services |
2103 |
Total Medical Submitted Charge Amount |
414169 |
Total Medical Medicare Allowed Amount |
88074.56 |
Total Medical Medicare Payment Amount |
68489.83 |
Total Medical Medicare Standardized Payment Amount |
63232.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
435 |
Number Of Beneficiaries Age 65 to 74 |
719 |
Number Of Beneficiaries Age 75 to 84 |
494 |
Number Of Beneficiaries Age Greater 84 |
455 |
Number Of Female Beneficiaries |
1204 |
Number Of Male Beneficiaries |
899 |
Number Of Non Hispanic White Beneficiaries |
941 |
Number Of Black or African American Beneficiaries |
666 |
Number Of AsianPacific Islander Beneficiaries |
225 |
Number Of Hispanic Beneficiaries |
212 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
994 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1608 |