| National Provider Identifier [NPI]: | 1174567044 |
| Last Name Of The Provider | LI |
| First Name Of The Provider | SHU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 40773 |
| Number Of Medicare Beneficiaries | 4871 |
| Total Submitted Charge Amount | 1653190.72 |
| Total Medicare Allowed Amount | 478492.18 |
| Total Medicare Payment Amount | 364599.56 |
| Total Medicare Standardized Payment Amount | 349234.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 34310 |
| Number Of Medicare Beneficiaries With Drug Services | 340 |
| Total Drug Submitted ChargeAmount | 8119.95 |
| Total Drug Medicare AllowedAmount | 6700.11 |
| Total Drug Medicare PaymentAmount | 4946.44 |
| Total Drug Medicare Standardized Payment Amount | 4946.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 134 |
| Number Of Medical Services | 6463 |
| Number Of Medicare Beneficiaries With Medical Services | 4871 |
| Total Medical Submitted Charge Amount | 1645070.77 |
| Total Medical Medicare Allowed Amount | 471792.07 |
| Total Medical Medicare Payment Amount | 359653.12 |
| Total Medical Medicare Standardized Payment Amount | 344288.55 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 531 |
| Number Of Beneficiaries Age 65 to 74 | 1973 |
| Number Of Beneficiaries Age 75 to 84 | 1500 |
| Number Of Beneficiaries Age Greater 84 | 867 |
| Number Of Female Beneficiaries | 3103 |
| Number Of Male Beneficiaries | 1768 |
| Number Of Non Hispanic White Beneficiaries | 3927 |
| Number Of Black or African American Beneficiaries | 778 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 602 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.491 |