| National Provider Identifier [NPI]: | 1851384903 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 18TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | TIFTON |
| Zip Code Of The Provider | 317943648 |
| 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 | 197 |
| Number Of Services | 9810 |
| Number Of Medicare Beneficiaries | 5255 |
| Total Submitted Charge Amount | 1304619 |
| Total Medicare Allowed Amount | 242542.24 |
| Total Medicare Payment Amount | 186504.82 |
| Total Medicare Standardized Payment Amount | 195145.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 197 |
| Number Of Medical Services | 9810 |
| Number Of Medicare Beneficiaries With Medical Services | 5255 |
| Total Medical Submitted Charge Amount | 1304619 |
| Total Medical Medicare Allowed Amount | 242542.24 |
| Total Medical Medicare Payment Amount | 186504.82 |
| Total Medical Medicare Standardized Payment Amount | 195145.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1122 |
| Number Of Beneficiaries Age 65 to 74 | 1988 |
| Number Of Beneficiaries Age 75 to 84 | 1519 |
| Number Of Beneficiaries Age Greater 84 | 626 |
| Number Of Female Beneficiaries | 3367 |
| Number Of Male Beneficiaries | 1888 |
| Number Of Non Hispanic White Beneficiaries | 4214 |
| Number Of Black or African American Beneficiaries | 944 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1959 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5141 |