| National Provider Identifier [NPI]: | 1417151481 |
| Last Name Of The Provider | LI |
| First Name Of The Provider | RUIZONG |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4301 W MARKHAM ST |
| Street Address 2 Of The Provider | UAMS/RADIOLOGY MAIL# 556 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722057101 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 3187 |
| Number Of Medicare Beneficiaries | 880 |
| Total Submitted Charge Amount | 2027668 |
| Total Medicare Allowed Amount | 238082.74 |
| Total Medicare Payment Amount | 184256.1 |
| Total Medicare Standardized Payment Amount | 197907.53 |
| 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 | 128 |
| Number Of Medical Services | 3187 |
| Number Of Medicare Beneficiaries With Medical Services | 880 |
| Total Medical Submitted Charge Amount | 2027668 |
| Total Medical Medicare Allowed Amount | 238082.74 |
| Total Medical Medicare Payment Amount | 184256.1 |
| Total Medical Medicare Standardized Payment Amount | 197907.53 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 312 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 456 |
| Number Of Non Hispanic White Beneficiaries | 655 |
| Number Of Black or African American Beneficiaries | 201 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.8233 |