| National Provider Identifier [NPI]: | 1023197126 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 W ARLINGTON BLVD STE 210 |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 278345758 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 6981 |
| Number Of Medicare Beneficiaries | 3544 |
| Total Submitted Charge Amount | 641512 |
| Total Medicare Allowed Amount | 198502.48 |
| Total Medicare Payment Amount | 147041.91 |
| Total Medicare Standardized Payment Amount | 153661.84 |
| 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 | 205 |
| Number Of Medical Services | 6981 |
| Number Of Medicare Beneficiaries With Medical Services | 3544 |
| Total Medical Submitted Charge Amount | 641512 |
| Total Medical Medicare Allowed Amount | 198502.48 |
| Total Medical Medicare Payment Amount | 147041.91 |
| Total Medical Medicare Standardized Payment Amount | 153661.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 657 |
| Number Of Beneficiaries Age 65 to 74 | 1484 |
| Number Of Beneficiaries Age 75 to 84 | 942 |
| Number Of Beneficiaries Age Greater 84 | 461 |
| Number Of Female Beneficiaries | 2329 |
| Number Of Male Beneficiaries | 1215 |
| Number Of Non Hispanic White Beneficiaries | 2484 |
| Number Of Black or African American Beneficiaries | 1009 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 945 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3526 |