| National Provider Identifier [NPI]: | 1972540201 |
| Last Name Of The Provider | SHAPIRO |
| First Name Of The Provider | BRADLEY |
| 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 | 111 BREWSTER ST |
| Street Address 2 Of The Provider | MEMORIAL X-RAY SERVICES. |
| City Of The Provider | PAWTUCKET |
| Zip Code Of The Provider | 028604400 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 240 |
| Number Of Services | 5221 |
| Number Of Medicare Beneficiaries | 2315 |
| Total Submitted Charge Amount | 776849 |
| Total Medicare Allowed Amount | 174241.69 |
| Total Medicare Payment Amount | 130968.54 |
| Total Medicare Standardized Payment Amount | 129070.27 |
| 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 | 240 |
| Number Of Medical Services | 5221 |
| Number Of Medicare Beneficiaries With Medical Services | 2315 |
| Total Medical Submitted Charge Amount | 776849 |
| Total Medical Medicare Allowed Amount | 174241.69 |
| Total Medical Medicare Payment Amount | 130968.54 |
| Total Medical Medicare Standardized Payment Amount | 129070.27 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 753 |
| Number Of Beneficiaries Age 65 to 74 | 639 |
| Number Of Beneficiaries Age 75 to 84 | 511 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 1424 |
| Number Of Male Beneficiaries | 891 |
| Number Of Non Hispanic White Beneficiaries | 1802 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 351 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1140 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6632 |