| National Provider Identifier [NPI]: | 1346287174 |
| Last Name Of The Provider | MAGRE |
| First Name Of The Provider | GEORGE |
| 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 | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 6287 |
| Number Of Medicare Beneficiaries | 4090 |
| Total Submitted Charge Amount | 1349973.78 |
| Total Medicare Allowed Amount | 219135.25 |
| Total Medicare Payment Amount | 168548.48 |
| Total Medicare Standardized Payment Amount | 174761.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1023 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 3763.18 |
| Total Drug Medicare AllowedAmount | 616.52 |
| Total Drug Medicare PaymentAmount | 483.37 |
| Total Drug Medicare Standardized Payment Amount | 483.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 5264 |
| Number Of Medicare Beneficiaries With Medical Services | 4090 |
| Total Medical Submitted Charge Amount | 1346210.6 |
| Total Medical Medicare Allowed Amount | 218518.73 |
| Total Medical Medicare Payment Amount | 168065.11 |
| Total Medical Medicare Standardized Payment Amount | 174278.23 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 688 |
| Number Of Beneficiaries Age 65 to 74 | 1395 |
| Number Of Beneficiaries Age 75 to 84 | 1224 |
| Number Of Beneficiaries Age Greater 84 | 783 |
| Number Of Female Beneficiaries | 2411 |
| Number Of Male Beneficiaries | 1679 |
| Number Of Non Hispanic White Beneficiaries | 3947 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2902 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1188 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4833 |