| National Provider Identifier [NPI]: | 1073520383 |
| Last Name Of The Provider | MOONEY |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 196 NORTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GENEVA |
| Zip Code Of The Provider | 144561651 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 5459 |
| Number Of Medicare Beneficiaries | 2283 |
| Total Submitted Charge Amount | 673874.7 |
| Total Medicare Allowed Amount | 171783.71 |
| Total Medicare Payment Amount | 129878.78 |
| Total Medicare Standardized Payment Amount | 138218.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 480 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2410 |
| Total Drug Medicare AllowedAmount | 952.66 |
| Total Drug Medicare PaymentAmount | 729.52 |
| Total Drug Medicare Standardized Payment Amount | 729.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 4979 |
| Number Of Medicare Beneficiaries With Medical Services | 2283 |
| Total Medical Submitted Charge Amount | 671464.7 |
| Total Medical Medicare Allowed Amount | 170831.05 |
| Total Medical Medicare Payment Amount | 129149.26 |
| Total Medical Medicare Standardized Payment Amount | 137489 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 662 |
| Number Of Beneficiaries Age 65 to 74 | 632 |
| Number Of Beneficiaries Age 75 to 84 | 540 |
| Number Of Beneficiaries Age Greater 84 | 449 |
| Number Of Female Beneficiaries | 1466 |
| Number Of Male Beneficiaries | 817 |
| Number Of Non Hispanic White Beneficiaries | 2086 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 965 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3065 |