| National Provider Identifier [NPI]: | 1073510723 |
| Last Name Of The Provider | DELANGE |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. PC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3273 DAVISON RD |
| Street Address 2 Of The Provider | STE 2 |
| City Of The Provider | LAPEER |
| Zip Code Of The Provider | 484462902 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1965 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 197041.13 |
| Total Medicare Allowed Amount | 147015.65 |
| Total Medicare Payment Amount | 99750.58 |
| Total Medicare Standardized Payment Amount | 108198.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 225 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 6300 |
| Total Drug Medicare AllowedAmount | 3177.17 |
| Total Drug Medicare PaymentAmount | 2807.96 |
| Total Drug Medicare Standardized Payment Amount | 2807.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1740 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 190741.13 |
| Total Medical Medicare Allowed Amount | 143838.48 |
| Total Medical Medicare Payment Amount | 96942.62 |
| Total Medical Medicare Standardized Payment Amount | 105390.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9957 |