| National Provider Identifier [NPI]: | 1659315067 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | NOEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 CAYLOR NICKEL SQ |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLUFFTON |
| Zip Code Of The Provider | 467142529 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 325 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 49961.11 |
| Total Medicare Allowed Amount | 19519.51 |
| Total Medicare Payment Amount | 13714.17 |
| Total Medicare Standardized Payment Amount | 14557.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 85 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2792 |
| Total Drug Medicare AllowedAmount | 130.07 |
| Total Drug Medicare PaymentAmount | 95.23 |
| Total Drug Medicare Standardized Payment Amount | 95.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 240 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 47169.11 |
| Total Medical Medicare Allowed Amount | 19389.44 |
| Total Medical Medicare Payment Amount | 13618.94 |
| Total Medical Medicare Standardized Payment Amount | 14462.04 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 41 |
| 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 | 75 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9817 |