| National Provider Identifier [NPI]: | 1538336565 |
| Last Name Of The Provider | LO |
| First Name Of The Provider | HAO |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1653 W CONGRESS PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123833 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 5028 |
| Number Of Medicare Beneficiaries | 2870 |
| Total Submitted Charge Amount | 488993 |
| Total Medicare Allowed Amount | 104485.8 |
| Total Medicare Payment Amount | 77797.91 |
| Total Medicare Standardized Payment Amount | 77625.12 |
| 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 | 107 |
| Number Of Medical Services | 5028 |
| Number Of Medicare Beneficiaries With Medical Services | 2870 |
| Total Medical Submitted Charge Amount | 488993 |
| Total Medical Medicare Allowed Amount | 104485.8 |
| Total Medical Medicare Payment Amount | 77797.91 |
| Total Medical Medicare Standardized Payment Amount | 77625.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 780 |
| Number Of Beneficiaries Age 65 to 74 | 802 |
| Number Of Beneficiaries Age 75 to 84 | 662 |
| Number Of Beneficiaries Age Greater 84 | 626 |
| Number Of Female Beneficiaries | 1576 |
| Number Of Male Beneficiaries | 1294 |
| Number Of Non Hispanic White Beneficiaries | 2442 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 239 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1200 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0541 |