| National Provider Identifier [NPI]: | 1154379576 |
| Last Name Of The Provider | SHAW |
| First Name Of The Provider | LIAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1003 PROVIDENCE DR |
| Street Address 2 Of The Provider | SUITE 325 |
| City Of The Provider | NEWBERG |
| Zip Code Of The Provider | 971327521 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1421 |
| Number Of Medicare Beneficiaries | 693 |
| Total Submitted Charge Amount | 354750 |
| Total Medicare Allowed Amount | 89869.46 |
| Total Medicare Payment Amount | 67251.97 |
| Total Medicare Standardized Payment Amount | 70096.95 |
| 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 | 53 |
| Number Of Medical Services | 1421 |
| Number Of Medicare Beneficiaries With Medical Services | 693 |
| Total Medical Submitted Charge Amount | 354750 |
| Total Medical Medicare Allowed Amount | 89869.46 |
| Total Medical Medicare Payment Amount | 67251.97 |
| Total Medical Medicare Standardized Payment Amount | 70096.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 250 |
| Number Of Beneficiaries Age 75 to 84 | 207 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 377 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 650 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5051 |