| National Provider Identifier [NPI]: | 1447408729 |
| Last Name Of The Provider | MOEN |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9301 N CENTRAL EXPY |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752310806 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3469 |
| Number Of Medicare Beneficiaries | 625 |
| Total Submitted Charge Amount | 1737838.84 |
| Total Medicare Allowed Amount | 362819.87 |
| Total Medicare Payment Amount | 271248.83 |
| Total Medicare Standardized Payment Amount | 278821.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 598 |
| Number Of Medicare Beneficiaries With Drug Services | 210 |
| Total Drug Submitted ChargeAmount | 1503.84 |
| Total Drug Medicare AllowedAmount | 1074.58 |
| Total Drug Medicare PaymentAmount | 762.25 |
| Total Drug Medicare Standardized Payment Amount | 762.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2871 |
| Number Of Medicare Beneficiaries With Medical Services | 625 |
| Total Medical Submitted Charge Amount | 1736335 |
| Total Medical Medicare Allowed Amount | 361745.29 |
| Total Medical Medicare Payment Amount | 270486.58 |
| Total Medical Medicare Standardized Payment Amount | 278059.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 313 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 337 |
| Number Of Male Beneficiaries | 288 |
| Number Of Non Hispanic White Beneficiaries | 569 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0657 |