| National Provider Identifier [NPI]: | 1437170180 |
| Last Name Of The Provider | HUNTZINGER |
| First Name Of The Provider | GRANT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1949 GUNBARREL RD |
| Street Address 2 Of The Provider | STE 170 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374213188 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 22272 |
| Number Of Medicare Beneficiaries | 2887 |
| Total Submitted Charge Amount | 1885753.11 |
| Total Medicare Allowed Amount | 356437.69 |
| Total Medicare Payment Amount | 273396.29 |
| Total Medicare Standardized Payment Amount | 303231.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 17716 |
| Number Of Medicare Beneficiaries With Drug Services | 291 |
| Total Drug Submitted ChargeAmount | 44292.11 |
| Total Drug Medicare AllowedAmount | 6378.87 |
| Total Drug Medicare PaymentAmount | 4916.44 |
| Total Drug Medicare Standardized Payment Amount | 4916.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 4556 |
| Number Of Medicare Beneficiaries With Medical Services | 2885 |
| Total Medical Submitted Charge Amount | 1841461 |
| Total Medical Medicare Allowed Amount | 350058.82 |
| Total Medical Medicare Payment Amount | 268479.85 |
| Total Medical Medicare Standardized Payment Amount | 298314.99 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 712 |
| Number Of Beneficiaries Age 65 to 74 | 1174 |
| Number Of Beneficiaries Age 75 to 84 | 742 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 1910 |
| Number Of Male Beneficiaries | 977 |
| Number Of Non Hispanic White Beneficiaries | 2574 |
| Number Of Black or African American Beneficiaries | 271 |
| 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 | 2026 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 861 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.409 |