| National Provider Identifier [NPI]: | 1033173067 |
| Last Name Of The Provider | BULLOCK |
| First Name Of The Provider | HUEY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4350 TOWNE CENTRE DR |
| Street Address 2 Of The Provider | SUITE 1000 |
| City Of The Provider | EVANS |
| Zip Code Of The Provider | 308093301 |
| 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 | 141 |
| Number Of Services | 5080 |
| Number Of Medicare Beneficiaries | 3303 |
| Total Submitted Charge Amount | 547944 |
| Total Medicare Allowed Amount | 109154.46 |
| Total Medicare Payment Amount | 86895.87 |
| Total Medicare Standardized Payment Amount | 90359.06 |
| 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 | 141 |
| Number Of Medical Services | 5080 |
| Number Of Medicare Beneficiaries With Medical Services | 3303 |
| Total Medical Submitted Charge Amount | 547944 |
| Total Medical Medicare Allowed Amount | 109154.46 |
| Total Medical Medicare Payment Amount | 86895.87 |
| Total Medical Medicare Standardized Payment Amount | 90359.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 501 |
| Number Of Beneficiaries Age 65 to 74 | 1316 |
| Number Of Beneficiaries Age 75 to 84 | 994 |
| Number Of Beneficiaries Age Greater 84 | 492 |
| Number Of Female Beneficiaries | 2176 |
| Number Of Male Beneficiaries | 1127 |
| Number Of Non Hispanic White Beneficiaries | 2383 |
| Number Of Black or African American Beneficiaries | 846 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 772 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.816 |