| National Provider Identifier [NPI]: | 1720031727 |
| Last Name Of The Provider | SHU |
| First Name Of The Provider | PAUL |
| 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 | 121 S SAINT LOUIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466172924 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 6627 |
| Number Of Medicare Beneficiaries | 3249 |
| Total Submitted Charge Amount | 744639.31 |
| Total Medicare Allowed Amount | 224788.67 |
| Total Medicare Payment Amount | 169248.38 |
| Total Medicare Standardized Payment Amount | 179132.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1352 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 3126.57 |
| Total Drug Medicare AllowedAmount | 2929.64 |
| Total Drug Medicare PaymentAmount | 2273.38 |
| Total Drug Medicare Standardized Payment Amount | 2273.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 5275 |
| Number Of Medicare Beneficiaries With Medical Services | 3249 |
| Total Medical Submitted Charge Amount | 741512.74 |
| Total Medical Medicare Allowed Amount | 221859.03 |
| Total Medical Medicare Payment Amount | 166975 |
| Total Medical Medicare Standardized Payment Amount | 176858.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 654 |
| Number Of Beneficiaries Age 65 to 74 | 1065 |
| Number Of Beneficiaries Age 75 to 84 | 886 |
| Number Of Beneficiaries Age Greater 84 | 644 |
| Number Of Female Beneficiaries | 1938 |
| Number Of Male Beneficiaries | 1311 |
| Number Of Non Hispanic White Beneficiaries | 2947 |
| Number Of Black or African American Beneficiaries | 209 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 875 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7442 |