| National Provider Identifier [NPI]: | 1285651752 |
| Last Name Of The Provider | MOEN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 HICKORY ST NW |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ALBANY |
| Zip Code Of The Provider | 973211700 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 944 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 91771.2 |
| Total Medicare Allowed Amount | 28756.17 |
| Total Medicare Payment Amount | 22079.15 |
| Total Medicare Standardized Payment Amount | 23327.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 737 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 39851 |
| Total Drug Medicare AllowedAmount | 15353.3 |
| Total Drug Medicare PaymentAmount | 11993.32 |
| Total Drug Medicare Standardized Payment Amount | 11993.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 207 |
| Number Of Medicare Beneficiaries With Medical Services | 113 |
| Total Medical Submitted Charge Amount | 51920.2 |
| Total Medical Medicare Allowed Amount | 13402.87 |
| Total Medical Medicare Payment Amount | 10085.83 |
| Total Medical Medicare Standardized Payment Amount | 11334.47 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 72 |
| Number Of Male Beneficiaries | 41 |
| 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 | 96 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9673 |