| National Provider Identifier [NPI]: | 1639190267 |
| Last Name Of The Provider | SHULL |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5901 TECHNOLOGY CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462786013 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 2105 |
| Number Of Medicare Beneficiaries | 1142 |
| Total Submitted Charge Amount | 162575 |
| Total Medicare Allowed Amount | 57502.89 |
| Total Medicare Payment Amount | 49053.38 |
| Total Medicare Standardized Payment Amount | 51868.79 |
| 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 | 60 |
| Number Of Medical Services | 2105 |
| Number Of Medicare Beneficiaries With Medical Services | 1142 |
| Total Medical Submitted Charge Amount | 162575 |
| Total Medical Medicare Allowed Amount | 57502.89 |
| Total Medical Medicare Payment Amount | 49053.38 |
| Total Medical Medicare Standardized Payment Amount | 51868.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 508 |
| Number Of Beneficiaries Age 75 to 84 | 358 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 992 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 1055 |
| Number Of Black or African American Beneficiaries | 66 |
| 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 | 969 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 173 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.118 |