| National Provider Identifier [NPI]: | 1851357214 |
| Last Name Of The Provider | GRISSOM |
| First Name Of The Provider | RHONDA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1218 S BROADWAY |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | LEXINGTON |
| Zip Code Of The Provider | 405042759 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 8932 |
| Number Of Medicare Beneficiaries | 4807 |
| Total Submitted Charge Amount | 707032 |
| Total Medicare Allowed Amount | 228100.69 |
| Total Medicare Payment Amount | 172959.98 |
| Total Medicare Standardized Payment Amount | 184120.35 |
| 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 | 190 |
| Number Of Medical Services | 8932 |
| Number Of Medicare Beneficiaries With Medical Services | 4807 |
| Total Medical Submitted Charge Amount | 707032 |
| Total Medical Medicare Allowed Amount | 228100.69 |
| Total Medical Medicare Payment Amount | 172959.98 |
| Total Medical Medicare Standardized Payment Amount | 184120.35 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1352 |
| Number Of Beneficiaries Age 65 to 74 | 1760 |
| Number Of Beneficiaries Age 75 to 84 | 1194 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 3146 |
| Number Of Male Beneficiaries | 1661 |
| Number Of Non Hispanic White Beneficiaries | 4556 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2967 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1840 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.381 |