| National Provider Identifier [NPI]: | 1467448886 |
| Last Name Of The Provider | ORDIWAY |
| First Name Of The Provider | GRANT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1801 N JACKSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TULLAHOMA |
| Zip Code Of The Provider | 373882201 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 7920 |
| Number Of Medicare Beneficiaries | 3420 |
| Total Submitted Charge Amount | 854279 |
| Total Medicare Allowed Amount | 216150.08 |
| Total Medicare Payment Amount | 168905.94 |
| Total Medicare Standardized Payment Amount | 178917.41 |
| 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 | 196 |
| Number Of Medical Services | 7920 |
| Number Of Medicare Beneficiaries With Medical Services | 3420 |
| Total Medical Submitted Charge Amount | 854279 |
| Total Medical Medicare Allowed Amount | 216150.08 |
| Total Medical Medicare Payment Amount | 168905.94 |
| Total Medical Medicare Standardized Payment Amount | 178917.41 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 780 |
| Number Of Beneficiaries Age 65 to 74 | 1238 |
| Number Of Beneficiaries Age 75 to 84 | 969 |
| Number Of Beneficiaries Age Greater 84 | 433 |
| Number Of Female Beneficiaries | 2120 |
| Number Of Male Beneficiaries | 1300 |
| Number Of Non Hispanic White Beneficiaries | 3259 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1001 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5339 |