| National Provider Identifier [NPI]: | 1750337101 |
| Last Name Of The Provider | RUST |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| 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 | 169 |
| Number Of Services | 6190 |
| Number Of Medicare Beneficiaries | 3311 |
| Total Submitted Charge Amount | 622361.53 |
| Total Medicare Allowed Amount | 191867.17 |
| Total Medicare Payment Amount | 144726.67 |
| Total Medicare Standardized Payment Amount | 153366.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1000 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 2175.21 |
| Total Drug Medicare AllowedAmount | 2169.11 |
| Total Drug Medicare PaymentAmount | 1698.3 |
| Total Drug Medicare Standardized Payment Amount | 1698.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 5190 |
| Number Of Medicare Beneficiaries With Medical Services | 3311 |
| Total Medical Submitted Charge Amount | 620186.32 |
| Total Medical Medicare Allowed Amount | 189698.06 |
| Total Medical Medicare Payment Amount | 143028.37 |
| Total Medical Medicare Standardized Payment Amount | 151667.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 564 |
| Number Of Beneficiaries Age 65 to 74 | 1124 |
| Number Of Beneficiaries Age 75 to 84 | 998 |
| Number Of Beneficiaries Age Greater 84 | 625 |
| Number Of Female Beneficiaries | 1985 |
| Number Of Male Beneficiaries | 1326 |
| Number Of Non Hispanic White Beneficiaries | 3004 |
| Number Of Black or African American Beneficiaries | 208 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2509 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 802 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6751 |