| National Provider Identifier [NPI]: | 1386644409 |
| Last Name Of The Provider | GRADY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 WIND RIDGE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014173 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 3608 |
| Number Of Medicare Beneficiaries | 1082 |
| Total Submitted Charge Amount | 2457051 |
| Total Medicare Allowed Amount | 407636.87 |
| Total Medicare Payment Amount | 314150.59 |
| Total Medicare Standardized Payment Amount | 325227.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 562 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 54440 |
| Total Drug Medicare AllowedAmount | 27840.9 |
| Total Drug Medicare PaymentAmount | 21713.05 |
| Total Drug Medicare Standardized Payment Amount | 21713.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 3046 |
| Number Of Medicare Beneficiaries With Medical Services | 1082 |
| Total Medical Submitted Charge Amount | 2402611 |
| Total Medical Medicare Allowed Amount | 379795.97 |
| Total Medical Medicare Payment Amount | 292437.54 |
| Total Medical Medicare Standardized Payment Amount | 303514.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 445 |
| Number Of Beneficiaries Age 75 to 84 | 372 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 494 |
| Number Of Male Beneficiaries | 588 |
| Number Of Non Hispanic White Beneficiaries | 1045 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 870 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4064 |