| National Provider Identifier [NPI]: | 1336276450 |
| Last Name Of The Provider | LIEN |
| First Name Of The Provider | CONWAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | STANFORD UNIVERSITY MEDICAL CENTER |
| Street Address 2 Of The Provider | 300 PASTEUR DRIVE, ROOM S047 |
| City Of The Provider | STANFORD |
| Zip Code Of The Provider | 94305 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 7614 |
| Number Of Medicare Beneficiaries | 4151 |
| Total Submitted Charge Amount | 919360.37 |
| Total Medicare Allowed Amount | 266085.98 |
| Total Medicare Payment Amount | 194123.6 |
| Total Medicare Standardized Payment Amount | 175964.64 |
| 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 | 194 |
| Number Of Medical Services | 7614 |
| Number Of Medicare Beneficiaries With Medical Services | 4151 |
| Total Medical Submitted Charge Amount | 919360.37 |
| Total Medical Medicare Allowed Amount | 266085.98 |
| Total Medical Medicare Payment Amount | 194123.6 |
| Total Medical Medicare Standardized Payment Amount | 175964.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 606 |
| Number Of Beneficiaries Age 65 to 74 | 1315 |
| Number Of Beneficiaries Age 75 to 84 | 1374 |
| Number Of Beneficiaries Age Greater 84 | 856 |
| Number Of Female Beneficiaries | 2544 |
| Number Of Male Beneficiaries | 1607 |
| Number Of Non Hispanic White Beneficiaries | 1380 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | 1376 |
| Number Of Hispanic Beneficiaries | 1158 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 89 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2579 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8806 |