| National Provider Identifier [NPI]: | 1376525022 |
| Last Name Of The Provider | SHI |
| First Name Of The Provider | ANN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST FND 216 |
| Street Address 2 Of The Provider | MASSACHUSETTS GENERAL HOSPITAL |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 3795 |
| Number Of Medicare Beneficiaries | 2741 |
| Total Submitted Charge Amount | 1089441.39 |
| Total Medicare Allowed Amount | 177813.95 |
| Total Medicare Payment Amount | 133159.3 |
| Total Medicare Standardized Payment Amount | 134073.37 |
| 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 | 188 |
| Number Of Medical Services | 3795 |
| Number Of Medicare Beneficiaries With Medical Services | 2741 |
| Total Medical Submitted Charge Amount | 1089441.39 |
| Total Medical Medicare Allowed Amount | 177813.95 |
| Total Medical Medicare Payment Amount | 133159.3 |
| Total Medical Medicare Standardized Payment Amount | 134073.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 448 |
| Number Of Beneficiaries Age 65 to 74 | 1103 |
| Number Of Beneficiaries Age 75 to 84 | 773 |
| Number Of Beneficiaries Age Greater 84 | 417 |
| Number Of Female Beneficiaries | 1603 |
| Number Of Male Beneficiaries | 1138 |
| Number Of Non Hispanic White Beneficiaries | 1934 |
| Number Of Black or African American Beneficiaries | 450 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | 268 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 480 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2023 |