| National Provider Identifier [NPI]: | 1477583284 |
| Last Name Of The Provider | MOSS |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 COOPER PLZ |
| Street Address 2 Of The Provider | COOPER UNIVERISTY RADIOLOGY |
| City Of The Provider | CAMDEN |
| Zip Code Of The Provider | 081031461 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 6064 |
| Number Of Medicare Beneficiaries | 3643 |
| Total Submitted Charge Amount | 257245 |
| Total Medicare Allowed Amount | 74543.85 |
| Total Medicare Payment Amount | 54980.16 |
| Total Medicare Standardized Payment Amount | 52386.41 |
| 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 | 95 |
| Number Of Medical Services | 6064 |
| Number Of Medicare Beneficiaries With Medical Services | 3643 |
| Total Medical Submitted Charge Amount | 257245 |
| Total Medical Medicare Allowed Amount | 74543.85 |
| Total Medical Medicare Payment Amount | 54980.16 |
| Total Medical Medicare Standardized Payment Amount | 52386.41 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 929 |
| Number Of Beneficiaries Age 65 to 74 | 1305 |
| Number Of Beneficiaries Age 75 to 84 | 883 |
| Number Of Beneficiaries Age Greater 84 | 526 |
| Number Of Female Beneficiaries | 2146 |
| Number Of Male Beneficiaries | 1497 |
| Number Of Non Hispanic White Beneficiaries | 2150 |
| Number Of Black or African American Beneficiaries | 819 |
| Number Of AsianPacific Islander Beneficiaries | 91 |
| Number Of Hispanic Beneficiaries | 534 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1295 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8009 |