| National Provider Identifier [NPI]: | 1053533703 |
| Last Name Of The Provider | DANIELS |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10 N GREENE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011524 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 218 |
| Number Of Services | 21305 |
| Number Of Medicare Beneficiaries | 2893 |
| Total Submitted Charge Amount | 1395914.39 |
| Total Medicare Allowed Amount | 416486.35 |
| Total Medicare Payment Amount | 323832.17 |
| Total Medicare Standardized Payment Amount | 327863.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 16469 |
| Number Of Medicare Beneficiaries With Drug Services | 342 |
| Total Drug Submitted ChargeAmount | 12907.03 |
| Total Drug Medicare AllowedAmount | 8043.29 |
| Total Drug Medicare PaymentAmount | 6277.11 |
| Total Drug Medicare Standardized Payment Amount | 6277.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 215 |
| Number Of Medical Services | 4836 |
| Number Of Medicare Beneficiaries With Medical Services | 2893 |
| Total Medical Submitted Charge Amount | 1383007.36 |
| Total Medical Medicare Allowed Amount | 408443.06 |
| Total Medical Medicare Payment Amount | 317555.06 |
| Total Medical Medicare Standardized Payment Amount | 321585.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 1250 |
| Number Of Beneficiaries Age 75 to 84 | 889 |
| Number Of Beneficiaries Age Greater 84 | 339 |
| Number Of Female Beneficiaries | 1819 |
| Number Of Male Beneficiaries | 1074 |
| Number Of Non Hispanic White Beneficiaries | 2572 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 141 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 397 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3563 |