| National Provider Identifier [NPI]: | 1225105323 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 421 CHESTNUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVANSVILLE |
| Zip Code Of The Provider | 477131227 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 6946 |
| Number Of Medicare Beneficiaries | 1316 |
| Total Submitted Charge Amount | 846810 |
| Total Medicare Allowed Amount | 384033.08 |
| Total Medicare Payment Amount | 283538.02 |
| Total Medicare Standardized Payment Amount | 297053.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1615 |
| Total Drug Medicare AllowedAmount | 169.22 |
| Total Drug Medicare PaymentAmount | 124.1 |
| Total Drug Medicare Standardized Payment Amount | 124.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 6851 |
| Number Of Medicare Beneficiaries With Medical Services | 1316 |
| Total Medical Submitted Charge Amount | 845195 |
| Total Medical Medicare Allowed Amount | 383863.86 |
| Total Medical Medicare Payment Amount | 283413.92 |
| Total Medical Medicare Standardized Payment Amount | 296929.14 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 540 |
| Number Of Beneficiaries Age 75 to 84 | 483 |
| Number Of Beneficiaries Age Greater 84 | 222 |
| Number Of Female Beneficiaries | 558 |
| Number Of Male Beneficiaries | 758 |
| Number Of Non Hispanic White Beneficiaries | 1290 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 1230 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0094 |