| National Provider Identifier [NPI]: | 1063413656 |
| Last Name Of The Provider | GROOM |
| First Name Of The Provider | KYLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 S RUNNELS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DE KALB |
| Zip Code Of The Provider | 755592317 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 4839 |
| Number Of Medicare Beneficiaries | 1033 |
| Total Submitted Charge Amount | 657397 |
| Total Medicare Allowed Amount | 268633.6 |
| Total Medicare Payment Amount | 187518.74 |
| Total Medicare Standardized Payment Amount | 202844.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1295 |
| Number Of Medicare Beneficiaries With Drug Services | 162 |
| Total Drug Submitted ChargeAmount | 9775 |
| Total Drug Medicare AllowedAmount | 1974.49 |
| Total Drug Medicare PaymentAmount | 1631.51 |
| Total Drug Medicare Standardized Payment Amount | 1631.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 3544 |
| Number Of Medicare Beneficiaries With Medical Services | 1031 |
| Total Medical Submitted Charge Amount | 647622 |
| Total Medical Medicare Allowed Amount | 266659.11 |
| Total Medical Medicare Payment Amount | 185887.23 |
| Total Medical Medicare Standardized Payment Amount | 201212.86 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 347 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 579 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 858 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 378 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5127 |