| National Provider Identifier [NPI]: | 1770590630 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 603 MONROE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 446222046 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2792.5 |
| Number Of Medicare Beneficiaries | 267 |
| Total Submitted Charge Amount | 161378 |
| Total Medicare Allowed Amount | 118113.9 |
| Total Medicare Payment Amount | 80601.08 |
| Total Medicare Standardized Payment Amount | 85746.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 359.5 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 7825 |
| Total Drug Medicare AllowedAmount | 5044.98 |
| Total Drug Medicare PaymentAmount | 4668 |
| Total Drug Medicare Standardized Payment Amount | 4668 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2433 |
| Number Of Medicare Beneficiaries With Medical Services | 267 |
| Total Medical Submitted Charge Amount | 153553 |
| Total Medical Medicare Allowed Amount | 113068.92 |
| Total Medical Medicare Payment Amount | 75933.08 |
| Total Medical Medicare Standardized Payment Amount | 81078.88 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0956 |