| National Provider Identifier [NPI]: | 1972524270 |
| Last Name Of The Provider | HULSEY |
| First Name Of The Provider | WAYNE |
| 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 | 333 ALCOVY ST |
| Street Address 2 Of The Provider | SUITE 9 |
| City Of The Provider | MONROE |
| Zip Code Of The Provider | 306552180 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 15027 |
| Number Of Medicare Beneficiaries | 2896 |
| Total Submitted Charge Amount | 1403193.98 |
| Total Medicare Allowed Amount | 357779.43 |
| Total Medicare Payment Amount | 277944.45 |
| Total Medicare Standardized Payment Amount | 282887.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5913 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 11972.9 |
| Total Drug Medicare AllowedAmount | 1552.91 |
| Total Drug Medicare PaymentAmount | 1171.17 |
| Total Drug Medicare Standardized Payment Amount | 1171.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 219 |
| Number Of Medical Services | 9114 |
| Number Of Medicare Beneficiaries With Medical Services | 2896 |
| Total Medical Submitted Charge Amount | 1391221.08 |
| Total Medical Medicare Allowed Amount | 356226.52 |
| Total Medical Medicare Payment Amount | 276773.28 |
| Total Medical Medicare Standardized Payment Amount | 281716.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 662 |
| Number Of Beneficiaries Age 65 to 74 | 1087 |
| Number Of Beneficiaries Age 75 to 84 | 725 |
| Number Of Beneficiaries Age Greater 84 | 422 |
| Number Of Female Beneficiaries | 1828 |
| Number Of Male Beneficiaries | 1068 |
| Number Of Non Hispanic White Beneficiaries | 2374 |
| Number Of Black or African American Beneficiaries | 457 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1945 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 951 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4685 |