| National Provider Identifier [NPI]: | 1639277494 |
| Last Name Of The Provider | GRABENSTEIN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 653 BRIARCLIFF AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK RIDGE |
| Zip Code Of The Provider | 378308799 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1606 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 109527.3 |
| Total Medicare Allowed Amount | 82243.98 |
| Total Medicare Payment Amount | 58996.53 |
| Total Medicare Standardized Payment Amount | 64424.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 113 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 3964 |
| Total Drug Medicare AllowedAmount | 2327.78 |
| Total Drug Medicare PaymentAmount | 2279.7 |
| Total Drug Medicare Standardized Payment Amount | 2279.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1493 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 105563.3 |
| Total Medical Medicare Allowed Amount | 79916.2 |
| Total Medical Medicare Payment Amount | 56716.83 |
| Total Medical Medicare Standardized Payment Amount | 62144.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 189 |
| Number Of Black or African American Beneficiaries | |
| 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 | 186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9443 |