| National Provider Identifier [NPI]: | 1790875318 |
| Last Name Of The Provider | OH |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3181 SW SAM JACKSON PARK RD |
| Street Address 2 Of The Provider | MAIL CODE L340 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972393011 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1164 |
| Number Of Medicare Beneficiaries | 607 |
| Total Submitted Charge Amount | 111422 |
| Total Medicare Allowed Amount | 35186.88 |
| Total Medicare Payment Amount | 28206.72 |
| Total Medicare Standardized Payment Amount | 28436.1 |
| 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 | 62 |
| Number Of Medical Services | 1164 |
| Number Of Medicare Beneficiaries With Medical Services | 607 |
| Total Medical Submitted Charge Amount | 111422 |
| Total Medical Medicare Allowed Amount | 35186.88 |
| Total Medical Medicare Payment Amount | 28206.72 |
| Total Medical Medicare Standardized Payment Amount | 28436.1 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 296 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 521 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 528 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 460 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.3539 |