| National Provider Identifier [NPI]: | 1235160573 |
| Last Name Of The Provider | MOORE |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6201 N SUNCOAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344286712 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1356 |
| Number Of Medicare Beneficiaries | 754 |
| Total Submitted Charge Amount | 1305420 |
| Total Medicare Allowed Amount | 156582.23 |
| Total Medicare Payment Amount | 119995.11 |
| Total Medicare Standardized Payment Amount | 117935.58 |
| 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 | 26 |
| Number Of Medical Services | 1356 |
| Number Of Medicare Beneficiaries With Medical Services | 754 |
| Total Medical Submitted Charge Amount | 1305420 |
| Total Medical Medicare Allowed Amount | 156582.23 |
| Total Medical Medicare Payment Amount | 119995.11 |
| Total Medical Medicare Standardized Payment Amount | 117935.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 195 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 471 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 604 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 344 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 410 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7685 |