| National Provider Identifier [NPI]: | 1811906993 |
| Last Name Of The Provider | GRANT |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3409 WORTH ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752462029 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Surgical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1605 |
| Number Of Medicare Beneficiaries | 1147 |
| Total Submitted Charge Amount | 219299.87 |
| Total Medicare Allowed Amount | 206191.19 |
| Total Medicare Payment Amount | 152977.01 |
| Total Medicare Standardized Payment Amount | 151453.52 |
| 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 | 26 |
| Number Of Medical Services | 1605 |
| Number Of Medicare Beneficiaries With Medical Services | 1147 |
| Total Medical Submitted Charge Amount | 219299.87 |
| Total Medical Medicare Allowed Amount | 206191.19 |
| Total Medical Medicare Payment Amount | 152977.01 |
| Total Medical Medicare Standardized Payment Amount | 151453.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 670 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 979 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 62 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8712 |