| National Provider Identifier [NPI]: | 1508941501 |
| Last Name Of The Provider | MOORE-WATERS |
| First Name Of The Provider | SONDI |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1428 SCOTT BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 300301424 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1764 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 109246 |
| Total Medicare Allowed Amount | 70768.75 |
| Total Medicare Payment Amount | 52229.02 |
| Total Medicare Standardized Payment Amount | 55323.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 2482 |
| Total Drug Medicare AllowedAmount | 1606.36 |
| Total Drug Medicare PaymentAmount | 1555.12 |
| Total Drug Medicare Standardized Payment Amount | 1555.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 1688 |
| Number Of Medicare Beneficiaries With Medical Services | 268 |
| Total Medical Submitted Charge Amount | 106764 |
| Total Medical Medicare Allowed Amount | 69162.39 |
| Total Medical Medicare Payment Amount | 50673.9 |
| Total Medical Medicare Standardized Payment Amount | 53768.05 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 212 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 169 |
| 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 | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0967 |