| National Provider Identifier [NPI]: | 1063473429 |
| Last Name Of The Provider | GEORGY |
| First Name Of The Provider | BASSEM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 488 E VALLEY PKWY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ESCONDIDO |
| Zip Code Of The Provider | 920253363 |
| 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 | 183 |
| Number Of Services | 4760 |
| Number Of Medicare Beneficiaries | 2298 |
| Total Submitted Charge Amount | 1350592.95 |
| Total Medicare Allowed Amount | 440720.85 |
| Total Medicare Payment Amount | 337196.36 |
| Total Medicare Standardized Payment Amount | 322037.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 539 |
| Number Of Medicare Beneficiaries With Drug Services | 211 |
| Total Drug Submitted ChargeAmount | 8005 |
| Total Drug Medicare AllowedAmount | 2814.32 |
| Total Drug Medicare PaymentAmount | 2201.58 |
| Total Drug Medicare Standardized Payment Amount | 2201.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 4221 |
| Number Of Medicare Beneficiaries With Medical Services | 2295 |
| Total Medical Submitted Charge Amount | 1342587.95 |
| Total Medical Medicare Allowed Amount | 437906.53 |
| Total Medical Medicare Payment Amount | 334994.78 |
| Total Medical Medicare Standardized Payment Amount | 319835.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 664 |
| Number Of Beneficiaries Age 75 to 84 | 710 |
| Number Of Beneficiaries Age Greater 84 | 615 |
| Number Of Female Beneficiaries | 1287 |
| Number Of Male Beneficiaries | 1011 |
| Number Of Non Hispanic White Beneficiaries | 1810 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | 127 |
| Number Of Hispanic Beneficiaries | 226 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1646 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 652 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9106 |