| National Provider Identifier [NPI]: | 1336135243 |
| Last Name Of The Provider | WAGGENSPACK |
| First Name Of The Provider | GERARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 S GEORGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | YORK |
| Zip Code Of The Provider | 174033676 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 14085 |
| Number Of Medicare Beneficiaries | 3175 |
| Total Submitted Charge Amount | 931603 |
| Total Medicare Allowed Amount | 259858.96 |
| Total Medicare Payment Amount | 199028.83 |
| Total Medicare Standardized Payment Amount | 217103.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 9540 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 13248 |
| Total Drug Medicare AllowedAmount | 3507.3 |
| Total Drug Medicare PaymentAmount | 2749.73 |
| Total Drug Medicare Standardized Payment Amount | 2749.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 4545 |
| Number Of Medicare Beneficiaries With Medical Services | 3175 |
| Total Medical Submitted Charge Amount | 918355 |
| Total Medical Medicare Allowed Amount | 256351.66 |
| Total Medical Medicare Payment Amount | 196279.1 |
| Total Medical Medicare Standardized Payment Amount | 214354.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 474 |
| Number Of Beneficiaries Age 65 to 74 | 1099 |
| Number Of Beneficiaries Age 75 to 84 | 955 |
| Number Of Beneficiaries Age Greater 84 | 647 |
| Number Of Female Beneficiaries | 1817 |
| Number Of Male Beneficiaries | 1358 |
| Number Of Non Hispanic White Beneficiaries | 2997 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 697 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5032 |