| National Provider Identifier [NPI]: | 1134360761 |
| Last Name Of The Provider | MOYNIHAN |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | P.A.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14555 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346136003 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 2058 |
| Number Of Medicare Beneficiaries | 377 |
| Total Submitted Charge Amount | 598102.56 |
| Total Medicare Allowed Amount | 100512.89 |
| Total Medicare Payment Amount | 77511.46 |
| Total Medicare Standardized Payment Amount | 84261.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1063 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 40949.08 |
| Total Drug Medicare AllowedAmount | 15275.42 |
| Total Drug Medicare PaymentAmount | 11895.47 |
| Total Drug Medicare Standardized Payment Amount | 11895.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 995 |
| Number Of Medicare Beneficiaries With Medical Services | 377 |
| Total Medical Submitted Charge Amount | 557153.48 |
| Total Medical Medicare Allowed Amount | 85237.47 |
| Total Medical Medicare Payment Amount | 65615.99 |
| Total Medical Medicare Standardized Payment Amount | 72366.41 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 334 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5747 |