National Provider Identifier [NPI]: |
1033204623 |
Last Name Of The Provider |
GRIMM |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9500 EUCLID AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441950001 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1964 |
Number Of Medicare Beneficiaries |
1199 |
Total Submitted Charge Amount |
1016183 |
Total Medicare Allowed Amount |
114025.3 |
Total Medicare Payment Amount |
86564.14 |
Total Medicare Standardized Payment Amount |
88712.76 |
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 |
30 |
Number Of Medical Services |
1964 |
Number Of Medicare Beneficiaries With Medical Services |
1199 |
Total Medical Submitted Charge Amount |
1016183 |
Total Medical Medicare Allowed Amount |
114025.3 |
Total Medical Medicare Payment Amount |
86564.14 |
Total Medical Medicare Standardized Payment Amount |
88712.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
189 |
Number Of Beneficiaries Age 65 to 74 |
477 |
Number Of Beneficiaries Age 75 to 84 |
395 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
489 |
Number Of Male Beneficiaries |
710 |
Number Of Non Hispanic White Beneficiaries |
996 |
Number Of Black or African American Beneficiaries |
162 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
992 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
40 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9736 |