| National Provider Identifier [NPI]: | 1013242098 |
| Last Name Of The Provider | LU |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | MASSACHUSETTS GENERAL HOSPITAL, DEPARTMENT OF RADIOLOGY |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| 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 | 41 |
| Number Of Services | 3778 |
| Number Of Medicare Beneficiaries | 508 |
| Total Submitted Charge Amount | 221876 |
| Total Medicare Allowed Amount | 52647.95 |
| Total Medicare Payment Amount | 40286.89 |
| Total Medicare Standardized Payment Amount | 38346.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3172 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 4685 |
| Total Drug Medicare AllowedAmount | 989.3 |
| Total Drug Medicare PaymentAmount | 775.6 |
| Total Drug Medicare Standardized Payment Amount | 775.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 606 |
| Number Of Medicare Beneficiaries With Medical Services | 507 |
| Total Medical Submitted Charge Amount | 217191 |
| Total Medical Medicare Allowed Amount | 51658.65 |
| Total Medical Medicare Payment Amount | 39511.29 |
| Total Medical Medicare Standardized Payment Amount | 37570.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 461 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0315 |