| National Provider Identifier [NPI]: | 1053631465 |
| Last Name Of The Provider | RAJKOWSKI |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5100 W BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432281607 |
| 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 | 104 |
| Number Of Services | 3491 |
| Number Of Medicare Beneficiaries | 2148 |
| Total Submitted Charge Amount | 623512 |
| Total Medicare Allowed Amount | 97984.13 |
| Total Medicare Payment Amount | 74758.06 |
| Total Medicare Standardized Payment Amount | 78681.85 |
| 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 | 104 |
| Number Of Medical Services | 3491 |
| Number Of Medicare Beneficiaries With Medical Services | 2148 |
| Total Medical Submitted Charge Amount | 623512 |
| Total Medical Medicare Allowed Amount | 97984.13 |
| Total Medical Medicare Payment Amount | 74758.06 |
| Total Medical Medicare Standardized Payment Amount | 78681.85 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 530 |
| Number Of Beneficiaries Age 65 to 74 | 585 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 491 |
| Number Of Female Beneficiaries | 1230 |
| Number Of Male Beneficiaries | 918 |
| Number Of Non Hispanic White Beneficiaries | 1756 |
| Number Of Black or African American Beneficiaries | 254 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 734 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0851 |