| National Provider Identifier [NPI]: | 1902858368 |
| Last Name Of The Provider | MEDNIK |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8425 W 3RD ST |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900484126 |
| 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 | 23 |
| Number Of Services | 3012 |
| Number Of Medicare Beneficiaries | 1236 |
| Total Submitted Charge Amount | 353122 |
| Total Medicare Allowed Amount | 188381.78 |
| Total Medicare Payment Amount | 145862.47 |
| Total Medicare Standardized Payment Amount | 133229.3 |
| 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 | 23 |
| Number Of Medical Services | 3012 |
| Number Of Medicare Beneficiaries With Medical Services | 1236 |
| Total Medical Submitted Charge Amount | 353122 |
| Total Medical Medicare Allowed Amount | 188381.78 |
| Total Medical Medicare Payment Amount | 145862.47 |
| Total Medical Medicare Standardized Payment Amount | 133229.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 376 |
| Number Of Beneficiaries Age 75 to 84 | 487 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 709 |
| Number Of Male Beneficiaries | 527 |
| Number Of Non Hispanic White Beneficiaries | 782 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 270 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 940 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4732 |