| National Provider Identifier [NPI]: | 1003018342 |
| Last Name Of The Provider | MOON |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3599 UNIVERSITY BLVD. S. |
| Street Address 2 Of The Provider | BLDG. 300 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 32216 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 279 |
| Number Of Services | 4649 |
| Number Of Medicare Beneficiaries | 2920 |
| Total Submitted Charge Amount | 902910 |
| Total Medicare Allowed Amount | 226048.41 |
| Total Medicare Payment Amount | 175381.33 |
| Total Medicare Standardized Payment Amount | 174035.57 |
| 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 | 279 |
| Number Of Medical Services | 4649 |
| Number Of Medicare Beneficiaries With Medical Services | 2920 |
| Total Medical Submitted Charge Amount | 902910 |
| Total Medical Medicare Allowed Amount | 226048.41 |
| Total Medical Medicare Payment Amount | 175381.33 |
| Total Medical Medicare Standardized Payment Amount | 174035.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 536 |
| Number Of Beneficiaries Age 65 to 74 | 1039 |
| Number Of Beneficiaries Age 75 to 84 | 844 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 1644 |
| Number Of Male Beneficiaries | 1276 |
| Number Of Non Hispanic White Beneficiaries | 2271 |
| Number Of Black or African American Beneficiaries | 467 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 111 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 803 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.3435 |