| National Provider Identifier [NPI]: | 1659467298 |
| Last Name Of The Provider | GEORGE |
| First Name Of The Provider | VERGHESE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6431 FANNIN ST |
| Street Address 2 Of The Provider | MSB 2.130B |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770301501 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 1085 |
| Number Of Medicare Beneficiaries | 816 |
| Total Submitted Charge Amount | 225266 |
| Total Medicare Allowed Amount | 44234.45 |
| Total Medicare Payment Amount | 33102.89 |
| Total Medicare Standardized Payment Amount | 33140.95 |
| 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 | 82 |
| Number Of Medical Services | 1085 |
| Number Of Medicare Beneficiaries With Medical Services | 816 |
| Total Medical Submitted Charge Amount | 225266 |
| Total Medical Medicare Allowed Amount | 44234.45 |
| Total Medical Medicare Payment Amount | 33102.89 |
| Total Medical Medicare Standardized Payment Amount | 33140.95 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 321 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 381 |
| Number Of Male Beneficiaries | 435 |
| Number Of Non Hispanic White Beneficiaries | 276 |
| Number Of Black or African American Beneficiaries | 321 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 191 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 433 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 383 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.8407 |