| National Provider Identifier [NPI]: | 1093757163 |
| Last Name Of The Provider | MOZENA |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 511 PARK HILL DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224013377 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3565 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 98753.6 |
| Total Medicare Allowed Amount | 57271.39 |
| Total Medicare Payment Amount | 42895.32 |
| Total Medicare Standardized Payment Amount | 42992.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1625 |
| Total Drug Medicare AllowedAmount | 502.13 |
| Total Drug Medicare PaymentAmount | 422.25 |
| Total Drug Medicare Standardized Payment Amount | 422.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 3411 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 97128.6 |
| Total Medical Medicare Allowed Amount | 56769.26 |
| Total Medical Medicare Payment Amount | 42473.07 |
| Total Medical Medicare Standardized Payment Amount | 42569.9 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 104 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 39 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9555 |