| National Provider Identifier [NPI]: | 1538271507 |
| Last Name Of The Provider | GRAEVE |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2800 10TH AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | BILLINGS |
| Zip Code Of The Provider | 591010703 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 5302 |
| Number Of Medicare Beneficiaries | 3302 |
| Total Submitted Charge Amount | 667049.17 |
| Total Medicare Allowed Amount | 154674.13 |
| Total Medicare Payment Amount | 121428.87 |
| Total Medicare Standardized Payment Amount | 122378.61 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 416 |
| Number Of Beneficiaries Age 65 to 74 | 1371 |
| Number Of Beneficiaries Age 75 to 84 | 1040 |
| Number Of Beneficiaries Age Greater 84 | 475 |
| Number Of Female Beneficiaries | 2220 |
| Number Of Male Beneficiaries | 1082 |
| Number Of Non Hispanic White Beneficiaries | 3047 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | 144 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2720 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 582 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2688 |