| National Provider Identifier [NPI]: | 1932109659 |
| Last Name Of The Provider | MORENO |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2639 OAK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322044505 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 8413 |
| Number Of Medicare Beneficiaries | 1505 |
| Total Submitted Charge Amount | 2030899 |
| Total Medicare Allowed Amount | 920670.1 |
| Total Medicare Payment Amount | 679653.03 |
| Total Medicare Standardized Payment Amount | 695162.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1658 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 352266 |
| Total Drug Medicare AllowedAmount | 225566.62 |
| Total Drug Medicare PaymentAmount | 171979.72 |
| Total Drug Medicare Standardized Payment Amount | 171979.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 6755 |
| Number Of Medicare Beneficiaries With Medical Services | 1505 |
| Total Medical Submitted Charge Amount | 1678633 |
| Total Medical Medicare Allowed Amount | 695103.48 |
| Total Medical Medicare Payment Amount | 507673.31 |
| Total Medical Medicare Standardized Payment Amount | 523183.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 614 |
| Number Of Beneficiaries Age 75 to 84 | 469 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 901 |
| Number Of Male Beneficiaries | 604 |
| Number Of Non Hispanic White Beneficiaries | 1204 |
| Number Of Black or African American Beneficiaries | 206 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4482 |