| National Provider Identifier [NPI]: | 1063474252 |
| Last Name Of The Provider | SHANNON |
| First Name Of The Provider | RHONDA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6720 BERTNER AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 77030 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3500 |
| Number Of Medicare Beneficiaries | 1493 |
| Total Submitted Charge Amount | 475477 |
| Total Medicare Allowed Amount | 86926.95 |
| Total Medicare Payment Amount | 67540.22 |
| Total Medicare Standardized Payment Amount | 55887.08 |
| 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 | 31 |
| Number Of Medical Services | 3500 |
| Number Of Medicare Beneficiaries With Medical Services | 1493 |
| Total Medical Submitted Charge Amount | 475477 |
| Total Medical Medicare Allowed Amount | 86926.95 |
| Total Medical Medicare Payment Amount | 67540.22 |
| Total Medical Medicare Standardized Payment Amount | 55887.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 269 |
| Number Of Beneficiaries Age 65 to 74 | 646 |
| Number Of Beneficiaries Age 75 to 84 | 416 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 854 |
| Number Of Non Hispanic White Beneficiaries | 968 |
| Number Of Black or African American Beneficiaries | 282 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 200 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 276 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.4028 |