| National Provider Identifier [NPI]: | 1164409769 |
| Last Name Of The Provider | ORRACA-TETTEH |
| First Name Of The Provider | KINGSLEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3525 OLENTANGY RIVER RD |
| Street Address 2 Of The Provider | STE 5360 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432143937 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 6624 |
| Number Of Medicare Beneficiaries | 2941 |
| Total Submitted Charge Amount | 563063.34 |
| Total Medicare Allowed Amount | 158932.68 |
| Total Medicare Payment Amount | 124477.13 |
| Total Medicare Standardized Payment Amount | 127819.03 |
| 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 | 180 |
| Number Of Medical Services | 6624 |
| Number Of Medicare Beneficiaries With Medical Services | 2941 |
| Total Medical Submitted Charge Amount | 563063.34 |
| Total Medical Medicare Allowed Amount | 158932.68 |
| Total Medical Medicare Payment Amount | 124477.13 |
| Total Medical Medicare Standardized Payment Amount | 127819.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 579 |
| Number Of Beneficiaries Age 65 to 74 | 1158 |
| Number Of Beneficiaries Age 75 to 84 | 836 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1882 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 2861 |
| Number Of Black or African American Beneficiaries | 19 |
| 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 | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 813 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2387 |