| National Provider Identifier [NPI]: | 1891874731 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | JAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14434 HAMLIN ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | VAN NUYS |
| Zip Code Of The Provider | 914011461 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 4552 |
| Number Of Medicare Beneficiaries | 2928 |
| Total Submitted Charge Amount | 503127 |
| Total Medicare Allowed Amount | 426549.52 |
| Total Medicare Payment Amount | 326659.66 |
| Total Medicare Standardized Payment Amount | 303555.64 |
| 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 | 24 |
| Number Of Medical Services | 4552 |
| Number Of Medicare Beneficiaries With Medical Services | 2928 |
| Total Medical Submitted Charge Amount | 503127 |
| Total Medical Medicare Allowed Amount | 426549.52 |
| Total Medical Medicare Payment Amount | 326659.66 |
| Total Medical Medicare Standardized Payment Amount | 303555.64 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 590 |
| Number Of Beneficiaries Age 75 to 84 | 789 |
| Number Of Beneficiaries Age Greater 84 | 1065 |
| Number Of Female Beneficiaries | 1739 |
| Number Of Male Beneficiaries | 1189 |
| Number Of Non Hispanic White Beneficiaries | 1552 |
| Number Of Black or African American Beneficiaries | 319 |
| Number Of AsianPacific Islander Beneficiaries | 345 |
| Number Of Hispanic Beneficiaries | 660 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2680 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 39 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 3.0426 |