| National Provider Identifier [NPI]: | 1649239054 |
| Last Name Of The Provider | GRUNDY |
| First Name Of The Provider | LAURENCE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 UNIVERSITY SQUARE DRIVE |
| Street Address 2 Of The Provider | RADIOLOGY ASSOCIATES OF TAMPA |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336125513 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 279 |
| Number Of Services | 8602 |
| Number Of Medicare Beneficiaries | 1659 |
| Total Submitted Charge Amount | 1498738.25 |
| Total Medicare Allowed Amount | 339409.22 |
| Total Medicare Payment Amount | 262145.58 |
| Total Medicare Standardized Payment Amount | 262213.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5233 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 7300.25 |
| Total Drug Medicare AllowedAmount | 1213.71 |
| Total Drug Medicare PaymentAmount | 922.8 |
| Total Drug Medicare Standardized Payment Amount | 922.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 277 |
| Number Of Medical Services | 3369 |
| Number Of Medicare Beneficiaries With Medical Services | 1658 |
| Total Medical Submitted Charge Amount | 1491438 |
| Total Medical Medicare Allowed Amount | 338195.51 |
| Total Medical Medicare Payment Amount | 261222.78 |
| Total Medical Medicare Standardized Payment Amount | 261290.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 460 |
| Number Of Beneficiaries Age 65 to 74 | 589 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 822 |
| Number Of Male Beneficiaries | 837 |
| Number Of Non Hispanic White Beneficiaries | 1203 |
| Number Of Black or African American Beneficiaries | 242 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 168 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 3.1751 |