| National Provider Identifier [NPI]: | 1184725558 |
| Last Name Of The Provider | MOELLER |
| First Name Of The Provider | DEREK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 208 COUNTRY CLUB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 388519326 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3137 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 145946 |
| Total Medicare Allowed Amount | 105445 |
| Total Medicare Payment Amount | 71322.35 |
| Total Medicare Standardized Payment Amount | 81347.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 596 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 4329 |
| Total Drug Medicare AllowedAmount | 2906.74 |
| Total Drug Medicare PaymentAmount | 2593.72 |
| Total Drug Medicare Standardized Payment Amount | 2593.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2541 |
| Number Of Medicare Beneficiaries With Medical Services | 360 |
| Total Medical Submitted Charge Amount | 141617 |
| Total Medical Medicare Allowed Amount | 102538.26 |
| Total Medical Medicare Payment Amount | 68728.63 |
| Total Medical Medicare Standardized Payment Amount | 78753.39 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 159 |
| Number Of Non Hispanic White Beneficiaries | 286 |
| 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 | 202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 158 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9567 |