| National Provider Identifier [NPI]: | 1154310589 |
| Last Name Of The Provider | MOVSON |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 5871 |
| Number Of Medicare Beneficiaries | 2809 |
| Total Submitted Charge Amount | 558407.5 |
| Total Medicare Allowed Amount | 192452.45 |
| Total Medicare Payment Amount | 158899.53 |
| Total Medicare Standardized Payment Amount | 154023.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1350 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 742.5 |
| Total Drug Medicare AllowedAmount | 229.55 |
| Total Drug Medicare PaymentAmount | 179.94 |
| Total Drug Medicare Standardized Payment Amount | 179.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 144 |
| Number Of Medical Services | 4521 |
| Number Of Medicare Beneficiaries With Medical Services | 2809 |
| Total Medical Submitted Charge Amount | 557665 |
| Total Medical Medicare Allowed Amount | 192222.9 |
| Total Medical Medicare Payment Amount | 158719.59 |
| Total Medical Medicare Standardized Payment Amount | 153843.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 569 |
| Number Of Beneficiaries Age 65 to 74 | 946 |
| Number Of Beneficiaries Age 75 to 84 | 717 |
| Number Of Beneficiaries Age Greater 84 | 577 |
| Number Of Female Beneficiaries | 1832 |
| Number Of Male Beneficiaries | 977 |
| Number Of Non Hispanic White Beneficiaries | 2260 |
| Number Of Black or African American Beneficiaries | 189 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 270 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 925 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7684 |