National Provider Identifier [NPI]: |
1699758128 |
Last Name Of The Provider |
MOORMAN |
First Name Of The Provider |
RITA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
280 S MAIN ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
ORANGE |
Zip Code Of The Provider |
928683852 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
88 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
84124 |
Total Medicare Allowed Amount |
18937.67 |
Total Medicare Payment Amount |
14794.24 |
Total Medicare Standardized Payment Amount |
14258.17 |
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 |
25 |
Number Of Medical Services |
88 |
Number Of Medicare Beneficiaries With Medical Services |
78 |
Total Medical Submitted Charge Amount |
84124 |
Total Medical Medicare Allowed Amount |
18937.67 |
Total Medical Medicare Payment Amount |
14794.24 |
Total Medical Medicare Standardized Payment Amount |
14258.17 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
45 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
|
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0385 |