| National Provider Identifier [NPI]: | 1427084433 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5804 COMMUNICATIONS PKWY STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750937810 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 5369 |
| Number Of Medicare Beneficiaries | 250 |
| Total Submitted Charge Amount | 856905 |
| Total Medicare Allowed Amount | 183915.64 |
| Total Medicare Payment Amount | 137641.57 |
| Total Medicare Standardized Payment Amount | 146890.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2803 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 55220 |
| Total Drug Medicare AllowedAmount | 18209.05 |
| Total Drug Medicare PaymentAmount | 14258.03 |
| Total Drug Medicare Standardized Payment Amount | 14258.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2566 |
| Number Of Medicare Beneficiaries With Medical Services | 250 |
| Total Medical Submitted Charge Amount | 801685 |
| Total Medical Medicare Allowed Amount | 165706.59 |
| Total Medical Medicare Payment Amount | 123383.54 |
| Total Medical Medicare Standardized Payment Amount | 132632.46 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0732 |