| National Provider Identifier [NPI]: | 1548213812 |
| Last Name Of The Provider | MOON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2814 SOFT HORIZON WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891351736 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 4936 |
| Number Of Medicare Beneficiaries | 3589 |
| Total Submitted Charge Amount | 689505 |
| Total Medicare Allowed Amount | 181542.55 |
| Total Medicare Payment Amount | 140820.74 |
| Total Medicare Standardized Payment Amount | 139250.73 |
| 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 | 117 |
| Number Of Medical Services | 4936 |
| Number Of Medicare Beneficiaries With Medical Services | 3589 |
| Total Medical Submitted Charge Amount | 689505 |
| Total Medical Medicare Allowed Amount | 181542.55 |
| Total Medical Medicare Payment Amount | 140820.74 |
| Total Medical Medicare Standardized Payment Amount | 139250.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 763 |
| Number Of Beneficiaries Age 65 to 74 | 1121 |
| Number Of Beneficiaries Age 75 to 84 | 1053 |
| Number Of Beneficiaries Age Greater 84 | 652 |
| Number Of Female Beneficiaries | 2038 |
| Number Of Male Beneficiaries | 1551 |
| Number Of Non Hispanic White Beneficiaries | 2564 |
| Number Of Black or African American Beneficiaries | 335 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 594 |
| Number Of American Indian Alaska Native Beneficiaries | 49 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1334 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0984 |