| National Provider Identifier [NPI]: | 1174783302 |
| Last Name Of The Provider | VU |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3417 ENSIGN RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065064 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3672 |
| Number Of Medicare Beneficiaries | 168 |
| Total Submitted Charge Amount | 94560.3 |
| Total Medicare Allowed Amount | 27969.75 |
| Total Medicare Payment Amount | 21854.26 |
| Total Medicare Standardized Payment Amount | 22162.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3430 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 2001.3 |
| Total Drug Medicare AllowedAmount | 873.59 |
| Total Drug Medicare PaymentAmount | 684.89 |
| Total Drug Medicare Standardized Payment Amount | 684.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 242 |
| Number Of Medicare Beneficiaries With Medical Services | 168 |
| Total Medical Submitted Charge Amount | 92559 |
| Total Medical Medicare Allowed Amount | 27096.16 |
| Total Medical Medicare Payment Amount | 21169.37 |
| Total Medical Medicare Standardized Payment Amount | 21477.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 155 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 144 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4513 |