| National Provider Identifier [NPI]: | 1457477176 |
| Last Name Of The Provider | MORENO |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 625 S FAIR OAKS AVE |
| Street Address 2 Of The Provider | SUITE #140 |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911052613 |
| 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 | 155 |
| Number Of Services | 18236 |
| Number Of Medicare Beneficiaries | 3668 |
| Total Submitted Charge Amount | 2089972.4 |
| Total Medicare Allowed Amount | 722065.24 |
| Total Medicare Payment Amount | 602745.32 |
| Total Medicare Standardized Payment Amount | 550721.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 11586 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 28867.4 |
| Total Drug Medicare AllowedAmount | 4427.47 |
| Total Drug Medicare PaymentAmount | 3452.77 |
| Total Drug Medicare Standardized Payment Amount | 3452.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 6650 |
| Number Of Medicare Beneficiaries With Medical Services | 3668 |
| Total Medical Submitted Charge Amount | 2061105 |
| Total Medical Medicare Allowed Amount | 717637.77 |
| Total Medical Medicare Payment Amount | 599292.55 |
| Total Medical Medicare Standardized Payment Amount | 547268.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 317 |
| Number Of Beneficiaries Age 65 to 74 | 1726 |
| Number Of Beneficiaries Age 75 to 84 | 1097 |
| Number Of Beneficiaries Age Greater 84 | 528 |
| Number Of Female Beneficiaries | 2859 |
| Number Of Male Beneficiaries | 809 |
| Number Of Non Hispanic White Beneficiaries | 2282 |
| Number Of Black or African American Beneficiaries | 290 |
| Number Of AsianPacific Islander Beneficiaries | 415 |
| Number Of Hispanic Beneficiaries | 580 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2672 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 996 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4564 |