| National Provider Identifier [NPI]: | 1649546284 |
| Last Name Of The Provider | MOON |
| First Name Of The Provider | JARED |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10607 RANDOLPH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CROWN POINT |
| Zip Code Of The Provider | 463077504 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 1788 |
| Number Of Medicare Beneficiaries | 402 |
| Total Submitted Charge Amount | 284411 |
| Total Medicare Allowed Amount | 118939.51 |
| Total Medicare Payment Amount | 89198.07 |
| Total Medicare Standardized Payment Amount | 96717.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 642 |
| Total Drug Medicare AllowedAmount | 60.52 |
| Total Drug Medicare PaymentAmount | 37.39 |
| Total Drug Medicare Standardized Payment Amount | 37.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 1684 |
| Number Of Medicare Beneficiaries With Medical Services | 402 |
| Total Medical Submitted Charge Amount | 283769 |
| Total Medical Medicare Allowed Amount | 118878.99 |
| Total Medical Medicare Payment Amount | 89160.68 |
| Total Medical Medicare Standardized Payment Amount | 96680.32 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 344 |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1876 |