| National Provider Identifier [NPI]: | 1194764779 |
| Last Name Of The Provider | MOSES |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 26859 PINE HOLLOW CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALENCIA |
| Zip Code Of The Provider | 913810615 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 1507 |
| Number Of Medicare Beneficiaries | 879 |
| Total Submitted Charge Amount | 74222 |
| Total Medicare Allowed Amount | 37220.81 |
| Total Medicare Payment Amount | 27631.19 |
| Total Medicare Standardized Payment Amount | 28506.58 |
| 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 | 128 |
| Number Of Medical Services | 1507 |
| Number Of Medicare Beneficiaries With Medical Services | 879 |
| Total Medical Submitted Charge Amount | 74222 |
| Total Medical Medicare Allowed Amount | 37220.81 |
| Total Medical Medicare Payment Amount | 27631.19 |
| Total Medical Medicare Standardized Payment Amount | 28506.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 338 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 550 |
| Number Of Male Beneficiaries | 329 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 482 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 522 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 357 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3887 |