| National Provider Identifier [NPI]: | 1558345454 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SUSANNA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT STREET FND 2 |
| Street Address 2 Of The Provider | RADIOLOGICAL ASSOCIATES |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142696 |
| 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 | 66 |
| Number Of Services | 10429 |
| Number Of Medicare Beneficiaries | 1628 |
| Total Submitted Charge Amount | 968521 |
| Total Medicare Allowed Amount | 224320.21 |
| Total Medicare Payment Amount | 170761.9 |
| Total Medicare Standardized Payment Amount | 158840.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 8395 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 21785 |
| Total Drug Medicare AllowedAmount | 5562.54 |
| Total Drug Medicare PaymentAmount | 4345.71 |
| Total Drug Medicare Standardized Payment Amount | 4345.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 2034 |
| Number Of Medicare Beneficiaries With Medical Services | 1628 |
| Total Medical Submitted Charge Amount | 946736 |
| Total Medical Medicare Allowed Amount | 218757.67 |
| Total Medical Medicare Payment Amount | 166416.19 |
| Total Medical Medicare Standardized Payment Amount | 154494.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 292 |
| Number Of Beneficiaries Age 65 to 74 | 695 |
| Number Of Beneficiaries Age 75 to 84 | 488 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 827 |
| Number Of Male Beneficiaries | 801 |
| Number Of Non Hispanic White Beneficiaries | 1435 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 403 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.978 |