| National Provider Identifier [NPI]: | 1598718066 |
| Last Name Of The Provider | YAMAGATA |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1317 N ELM ST |
| Street Address 2 Of The Provider | SUITE 1B |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274011023 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 6072 |
| Number Of Medicare Beneficiaries | 2145 |
| Total Submitted Charge Amount | 499104.75 |
| Total Medicare Allowed Amount | 150627.88 |
| Total Medicare Payment Amount | 113100.53 |
| Total Medicare Standardized Payment Amount | 119691.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3078 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1077.75 |
| Total Drug Medicare AllowedAmount | 524.83 |
| Total Drug Medicare PaymentAmount | 411.53 |
| Total Drug Medicare Standardized Payment Amount | 411.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 213 |
| Number Of Medical Services | 2994 |
| Number Of Medicare Beneficiaries With Medical Services | 2145 |
| Total Medical Submitted Charge Amount | 498027 |
| Total Medical Medicare Allowed Amount | 150103.05 |
| Total Medical Medicare Payment Amount | 112689 |
| Total Medical Medicare Standardized Payment Amount | 119279.69 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 497 |
| Number Of Beneficiaries Age 65 to 74 | 711 |
| Number Of Beneficiaries Age 75 to 84 | 578 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1243 |
| Number Of Male Beneficiaries | 902 |
| Number Of Non Hispanic White Beneficiaries | 1615 |
| Number Of Black or African American Beneficiaries | 478 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 735 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0898 |