| National Provider Identifier [NPI]: | 1275598013 |
| Last Name Of The Provider | GRIMES |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2981 W 4TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ONTARIO |
| Zip Code Of The Provider | 449061267 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 1063 |
| Number Of Medicare Beneficiaries | 546 |
| Total Submitted Charge Amount | 290429.9 |
| Total Medicare Allowed Amount | 122191.78 |
| Total Medicare Payment Amount | 85753.84 |
| Total Medicare Standardized Payment Amount | 91110.47 |
| 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 | 66 |
| Number Of Medical Services | 1063 |
| Number Of Medicare Beneficiaries With Medical Services | 546 |
| Total Medical Submitted Charge Amount | 290429.9 |
| Total Medical Medicare Allowed Amount | 122191.78 |
| Total Medical Medicare Payment Amount | 85753.84 |
| Total Medical Medicare Standardized Payment Amount | 91110.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 515 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1345 |