| National Provider Identifier [NPI]: | 1013038967 |
| Last Name Of The Provider | LIU |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| 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 | GRB 293 |
| 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 | 114 |
| Number Of Services | 2850 |
| Number Of Medicare Beneficiaries | 603 |
| Total Submitted Charge Amount | 963647.76 |
| Total Medicare Allowed Amount | 140580.48 |
| Total Medicare Payment Amount | 107123.37 |
| Total Medicare Standardized Payment Amount | 103622.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1578 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1883.76 |
| Total Drug Medicare AllowedAmount | 594.29 |
| Total Drug Medicare PaymentAmount | 465.95 |
| Total Drug Medicare Standardized Payment Amount | 465.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 1272 |
| Number Of Medicare Beneficiaries With Medical Services | 602 |
| Total Medical Submitted Charge Amount | 961764 |
| Total Medical Medicare Allowed Amount | 139986.19 |
| Total Medical Medicare Payment Amount | 106657.42 |
| Total Medical Medicare Standardized Payment Amount | 103157.02 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 283 |
| Number Of Male Beneficiaries | 320 |
| Number Of Non Hispanic White Beneficiaries | 502 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 422 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.2728 |