| National Provider Identifier [NPI]: | 1063498400 |
| Last Name Of The Provider | BENASHVILI |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 710 CENTER ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 319011527 |
| 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 | 156 |
| Number Of Services | 12078 |
| Number Of Medicare Beneficiaries | 3312 |
| Total Submitted Charge Amount | 1885618.4 |
| Total Medicare Allowed Amount | 292834.27 |
| Total Medicare Payment Amount | 218187.83 |
| Total Medicare Standardized Payment Amount | 237859.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6699 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 28934 |
| Total Drug Medicare AllowedAmount | 3502.28 |
| Total Drug Medicare PaymentAmount | 2709.09 |
| Total Drug Medicare Standardized Payment Amount | 2709.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 154 |
| Number Of Medical Services | 5379 |
| Number Of Medicare Beneficiaries With Medical Services | 3312 |
| Total Medical Submitted Charge Amount | 1856684.4 |
| Total Medical Medicare Allowed Amount | 289331.99 |
| Total Medical Medicare Payment Amount | 215478.74 |
| Total Medical Medicare Standardized Payment Amount | 235150.81 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 902 |
| Number Of Beneficiaries Age 65 to 74 | 1189 |
| Number Of Beneficiaries Age 75 to 84 | 847 |
| Number Of Beneficiaries Age Greater 84 | 374 |
| Number Of Female Beneficiaries | 1975 |
| Number Of Male Beneficiaries | 1337 |
| Number Of Non Hispanic White Beneficiaries | 1965 |
| Number Of Black or African American Beneficiaries | 1237 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2240 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1072 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7584 |