| National Provider Identifier [NPI]: | 1790992956 |
| Last Name Of The Provider | SKLYAREVSKAYA |
| First Name Of The Provider | TATYANA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 770 PINE ST STE 290 |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312017516 |
| 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 | 188 |
| Number Of Services | 7679 |
| Number Of Medicare Beneficiaries | 3555 |
| Total Submitted Charge Amount | 1139206 |
| Total Medicare Allowed Amount | 267653.8 |
| Total Medicare Payment Amount | 202988.41 |
| Total Medicare Standardized Payment Amount | 219047.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2482 |
| Number Of Medicare Beneficiaries With Drug Services | 175 |
| Total Drug Submitted ChargeAmount | 29370 |
| Total Drug Medicare AllowedAmount | 3984.6 |
| Total Drug Medicare PaymentAmount | 3078.98 |
| Total Drug Medicare Standardized Payment Amount | 3078.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 5197 |
| Number Of Medicare Beneficiaries With Medical Services | 3555 |
| Total Medical Submitted Charge Amount | 1109836 |
| Total Medical Medicare Allowed Amount | 263669.2 |
| Total Medical Medicare Payment Amount | 199909.43 |
| Total Medical Medicare Standardized Payment Amount | 215968.9 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 895 |
| Number Of Beneficiaries Age 65 to 74 | 1300 |
| Number Of Beneficiaries Age 75 to 84 | 940 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1947 |
| Number Of Male Beneficiaries | 1608 |
| Number Of Non Hispanic White Beneficiaries | 2323 |
| Number Of Black or African American Beneficiaries | 1174 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1141 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0061 |