| National Provider Identifier [NPI]: | 1992752265 |
| Last Name Of The Provider | WAGNER |
| First Name Of The Provider | GEORGE |
| 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 | 4983 DELHI AVE |
| Street Address 2 Of The Provider | SUITE 6 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452385380 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 4363 |
| Number Of Medicare Beneficiaries | 2544 |
| Total Submitted Charge Amount | 435613 |
| Total Medicare Allowed Amount | 140089.81 |
| Total Medicare Payment Amount | 110214.4 |
| Total Medicare Standardized Payment Amount | 114398.61 |
| 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 | 191 |
| Number Of Medical Services | 4363 |
| Number Of Medicare Beneficiaries With Medical Services | 2544 |
| Total Medical Submitted Charge Amount | 435613 |
| Total Medical Medicare Allowed Amount | 140089.81 |
| Total Medical Medicare Payment Amount | 110214.4 |
| Total Medical Medicare Standardized Payment Amount | 114398.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 483 |
| Number Of Beneficiaries Age 65 to 74 | 806 |
| Number Of Beneficiaries Age 75 to 84 | 731 |
| Number Of Beneficiaries Age Greater 84 | 524 |
| Number Of Female Beneficiaries | 1745 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 2207 |
| Number Of Black or African American Beneficiaries | 290 |
| 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 | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1888 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 656 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6131 |