| National Provider Identifier [NPI]: | 1699768184 |
| Last Name Of The Provider | MORENO |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 SUNNYBROOK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | POTTSTOWN |
| Zip Code Of The Provider | 194643213 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 5372 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 945030.25 |
| Total Medicare Allowed Amount | 304984.06 |
| Total Medicare Payment Amount | 228020.44 |
| Total Medicare Standardized Payment Amount | 219542.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 2109 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 138793.05 |
| Total Drug Medicare AllowedAmount | 36141.96 |
| Total Drug Medicare PaymentAmount | 28261.65 |
| Total Drug Medicare Standardized Payment Amount | 28261.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 3263 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 806237.2 |
| Total Medical Medicare Allowed Amount | 268842.1 |
| Total Medical Medicare Payment Amount | 199758.79 |
| Total Medical Medicare Standardized Payment Amount | 191280.88 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 242 |
| Number Of Male Beneficiaries | 491 |
| Number Of Non Hispanic White Beneficiaries | 685 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5492 |