| National Provider Identifier [NPI]: | 1477509156 |
| Last Name Of The Provider | YANG |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 S SAINT LOUIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466172924 |
| 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 | 171 |
| Number Of Services | 5946 |
| Number Of Medicare Beneficiaries | 2947 |
| Total Submitted Charge Amount | 611948.49 |
| Total Medicare Allowed Amount | 195310.37 |
| Total Medicare Payment Amount | 145245.76 |
| Total Medicare Standardized Payment Amount | 154499.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1473 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 3352.29 |
| Total Drug Medicare AllowedAmount | 3154.39 |
| Total Drug Medicare PaymentAmount | 2436.73 |
| Total Drug Medicare Standardized Payment Amount | 2436.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 4473 |
| Number Of Medicare Beneficiaries With Medical Services | 2947 |
| Total Medical Submitted Charge Amount | 608596.2 |
| Total Medical Medicare Allowed Amount | 192155.98 |
| Total Medical Medicare Payment Amount | 142809.03 |
| Total Medical Medicare Standardized Payment Amount | 152062.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 603 |
| Number Of Beneficiaries Age 65 to 74 | 951 |
| Number Of Beneficiaries Age 75 to 84 | 841 |
| Number Of Beneficiaries Age Greater 84 | 552 |
| Number Of Female Beneficiaries | 1768 |
| Number Of Male Beneficiaries | 1179 |
| Number Of Non Hispanic White Beneficiaries | 2672 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 814 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7137 |