| National Provider Identifier [NPI]: | 1184635880 |
| Last Name Of The Provider | MOEN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1068 NATIONAL HIGHWAY REAR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CUMBERLAND |
| Zip Code Of The Provider | 215027501 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 4432 |
| Number Of Medicare Beneficiaries | 648 |
| Total Submitted Charge Amount | 249982.36 |
| Total Medicare Allowed Amount | 238366.61 |
| Total Medicare Payment Amount | 165378.04 |
| Total Medicare Standardized Payment Amount | 155778.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 375 |
| Number Of Medicare Beneficiaries With Drug Services | 367 |
| Total Drug Submitted ChargeAmount | 8740 |
| Total Drug Medicare AllowedAmount | 6626.42 |
| Total Drug Medicare PaymentAmount | 6493.13 |
| Total Drug Medicare Standardized Payment Amount | 6493.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 4057 |
| Number Of Medicare Beneficiaries With Medical Services | 648 |
| Total Medical Submitted Charge Amount | 241242.36 |
| Total Medical Medicare Allowed Amount | 231740.19 |
| Total Medical Medicare Payment Amount | 158884.91 |
| Total Medical Medicare Standardized Payment Amount | 149285.11 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 391 |
| Number Of Male Beneficiaries | 257 |
| Number Of Non Hispanic White Beneficiaries | 637 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 573 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.039 |