| National Provider Identifier [NPI]: | 1003904541 |
| Last Name Of The Provider | MORA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D., M.P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 506 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112153609 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 4696 |
| Number Of Medicare Beneficiaries | 3202 |
| Total Submitted Charge Amount | 503068.23 |
| Total Medicare Allowed Amount | 157473.96 |
| Total Medicare Payment Amount | 117509.29 |
| Total Medicare Standardized Payment Amount | 114547.96 |
| 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 | 158 |
| Number Of Medical Services | 4696 |
| Number Of Medicare Beneficiaries With Medical Services | 3202 |
| Total Medical Submitted Charge Amount | 503068.23 |
| Total Medical Medicare Allowed Amount | 157473.96 |
| Total Medical Medicare Payment Amount | 117509.29 |
| Total Medical Medicare Standardized Payment Amount | 114547.96 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 991 |
| Number Of Beneficiaries Age 65 to 74 | 1003 |
| Number Of Beneficiaries Age 75 to 84 | 759 |
| Number Of Beneficiaries Age Greater 84 | 449 |
| Number Of Female Beneficiaries | 1869 |
| Number Of Male Beneficiaries | 1333 |
| Number Of Non Hispanic White Beneficiaries | 2615 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 186 |
| Number Of Hispanic Beneficiaries | 326 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1732 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1470 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6643 |