| National Provider Identifier [NPI]: | 1942439740 |
| Last Name Of The Provider | MOELLER |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | SUITE 504, 44-46 PORTLAND STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | DARTMOUTH |
| Zip Code Of The Provider | B2Y 1H4 |
| State Code Of The Provider | ZZ |
| Country Code Of The Provider | CA |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 390 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 179532 |
| Total Medicare Allowed Amount | 47726.92 |
| Total Medicare Payment Amount | 36298.55 |
| Total Medicare Standardized Payment Amount | 34187.91 |
| 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 | 21 |
| Number Of Medical Services | 390 |
| Number Of Medicare Beneficiaries With Medical Services | 192 |
| Total Medical Submitted Charge Amount | 179532 |
| Total Medical Medicare Allowed Amount | 47726.92 |
| Total Medical Medicare Payment Amount | 36298.55 |
| Total Medical Medicare Standardized Payment Amount | 34187.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 129 |
| Number Of Black or African American Beneficiaries | 41 |
| 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 | 93 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 41 |
| Average HCC Risk Score Of Beneficiaries | 2.2654 |