| National Provider Identifier [NPI]: | 1528239308 |
| Last Name Of The Provider | OTTEN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11108 PARKVIEW CIRCLE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468451730 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 3050 |
| Number Of Medicare Beneficiaries | 1740 |
| Total Submitted Charge Amount | 1276766.4 |
| Total Medicare Allowed Amount | 265487.76 |
| Total Medicare Payment Amount | 194583.43 |
| Total Medicare Standardized Payment Amount | 207252.58 |
| 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 | 95 |
| Number Of Medical Services | 3050 |
| Number Of Medicare Beneficiaries With Medical Services | 1740 |
| Total Medical Submitted Charge Amount | 1276766.4 |
| Total Medical Medicare Allowed Amount | 265487.76 |
| Total Medical Medicare Payment Amount | 194583.43 |
| Total Medical Medicare Standardized Payment Amount | 207252.58 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 505 |
| Number Of Beneficiaries Age 75 to 84 | 596 |
| Number Of Beneficiaries Age Greater 84 | 450 |
| Number Of Female Beneficiaries | 800 |
| Number Of Male Beneficiaries | 940 |
| Number Of Non Hispanic White Beneficiaries | 1663 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1459 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 281 |
| Percent Of With Atrial Fibrillation | 40 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6807 |