| National Provider Identifier [NPI]: | 1306811153 |
| Last Name Of The Provider | SHAUGHNESS |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4516 N ARMENIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 33603 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 4139 |
| Number Of Medicare Beneficiaries | 2033 |
| Total Submitted Charge Amount | 561240.8 |
| Total Medicare Allowed Amount | 123310.28 |
| Total Medicare Payment Amount | 90993.89 |
| Total Medicare Standardized Payment Amount | 91891.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1130 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 3055.8 |
| Total Drug Medicare AllowedAmount | 308.92 |
| Total Drug Medicare PaymentAmount | 228.61 |
| Total Drug Medicare Standardized Payment Amount | 228.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 3009 |
| Number Of Medicare Beneficiaries With Medical Services | 2032 |
| Total Medical Submitted Charge Amount | 558185 |
| Total Medical Medicare Allowed Amount | 123001.36 |
| Total Medical Medicare Payment Amount | 90765.28 |
| Total Medical Medicare Standardized Payment Amount | 91663.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 443 |
| Number Of Beneficiaries Age 65 to 74 | 553 |
| Number Of Beneficiaries Age 75 to 84 | 559 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 1193 |
| Number Of Male Beneficiaries | 840 |
| Number Of Non Hispanic White Beneficiaries | 1343 |
| Number Of Black or African American Beneficiaries | 297 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 355 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1190 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 843 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2145 |