| National Provider Identifier [NPI]: | 1982712162 |
| Last Name Of The Provider | SHIH |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5001 US HIGHWAY 30 W STE D |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468189701 |
| 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 | 73 |
| Number Of Services | 2766 |
| Number Of Medicare Beneficiaries | 2185 |
| Total Submitted Charge Amount | 663916.99 |
| Total Medicare Allowed Amount | 158439.07 |
| Total Medicare Payment Amount | 119280.93 |
| Total Medicare Standardized Payment Amount | 121782.13 |
| 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 | 73 |
| Number Of Medical Services | 2766 |
| Number Of Medicare Beneficiaries With Medical Services | 2185 |
| Total Medical Submitted Charge Amount | 663916.99 |
| Total Medical Medicare Allowed Amount | 158439.07 |
| Total Medical Medicare Payment Amount | 119280.93 |
| Total Medical Medicare Standardized Payment Amount | 121782.13 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 574 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 415 |
| Number Of Female Beneficiaries | 1300 |
| Number Of Male Beneficiaries | 885 |
| Number Of Non Hispanic White Beneficiaries | 2014 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1377 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 808 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 1.609 |