| National Provider Identifier [NPI]: | 1285670927 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4 HOLLY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | SETAUKET |
| Zip Code Of The Provider | 117331612 |
| 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 | 137 |
| Number Of Services | 5486 |
| Number Of Medicare Beneficiaries | 3260 |
| Total Submitted Charge Amount | 911529 |
| Total Medicare Allowed Amount | 170294.84 |
| Total Medicare Payment Amount | 128634.64 |
| Total Medicare Standardized Payment Amount | 116974.59 |
| 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 | 137 |
| Number Of Medical Services | 5486 |
| Number Of Medicare Beneficiaries With Medical Services | 3260 |
| Total Medical Submitted Charge Amount | 911529 |
| Total Medical Medicare Allowed Amount | 170294.84 |
| Total Medical Medicare Payment Amount | 128634.64 |
| Total Medical Medicare Standardized Payment Amount | 116974.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 525 |
| Number Of Beneficiaries Age 65 to 74 | 1050 |
| Number Of Beneficiaries Age 75 to 84 | 993 |
| Number Of Beneficiaries Age Greater 84 | 692 |
| Number Of Female Beneficiaries | 1697 |
| Number Of Male Beneficiaries | 1563 |
| Number Of Non Hispanic White Beneficiaries | 2883 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 860 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1737 |