| National Provider Identifier [NPI]: | 1023014008 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | JEFFREY |
| 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 | 150 RIVER NORTH BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STEPHENVILLE |
| Zip Code Of The Provider | 764011803 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 14277 |
| Number Of Medicare Beneficiaries | 680 |
| Total Submitted Charge Amount | 902553.45 |
| Total Medicare Allowed Amount | 439342.27 |
| Total Medicare Payment Amount | 340466.83 |
| Total Medicare Standardized Payment Amount | 354630.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 644 |
| Number Of Medicare Beneficiaries With Drug Services | 243 |
| Total Drug Submitted ChargeAmount | 16937 |
| Total Drug Medicare AllowedAmount | 8405.96 |
| Total Drug Medicare PaymentAmount | 7245.95 |
| Total Drug Medicare Standardized Payment Amount | 7245.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 13633 |
| Number Of Medicare Beneficiaries With Medical Services | 680 |
| Total Medical Submitted Charge Amount | 885616.45 |
| Total Medical Medicare Allowed Amount | 430936.31 |
| Total Medical Medicare Payment Amount | 333220.88 |
| Total Medical Medicare Standardized Payment Amount | 347384.19 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 256 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 266 |
| 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 | 603 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1503 |