| National Provider Identifier [NPI]: | 1336106533 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | LISL |
| 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 | LAHEY CLINIC/RADIOLOGY |
| Street Address 2 Of The Provider | 41 MALL ROAD |
| City Of The Provider | BURLINGTON |
| Zip Code Of The Provider | 018050001 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 4428 |
| Number Of Medicare Beneficiaries | 2922 |
| Total Submitted Charge Amount | 312286 |
| Total Medicare Allowed Amount | 89074.6 |
| Total Medicare Payment Amount | 67020.7 |
| Total Medicare Standardized Payment Amount | 64585.13 |
| 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 | 120 |
| Number Of Medical Services | 4428 |
| Number Of Medicare Beneficiaries With Medical Services | 2922 |
| Total Medical Submitted Charge Amount | 312286 |
| Total Medical Medicare Allowed Amount | 89074.6 |
| Total Medical Medicare Payment Amount | 67020.7 |
| Total Medical Medicare Standardized Payment Amount | 64585.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 987 |
| Number Of Beneficiaries Age 75 to 84 | 948 |
| Number Of Beneficiaries Age Greater 84 | 595 |
| Number Of Female Beneficiaries | 1737 |
| Number Of Male Beneficiaries | 1185 |
| Number Of Non Hispanic White Beneficiaries | 2720 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2344 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 578 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5921 |