| National Provider Identifier [NPI]: | 1255365441 |
| Last Name Of The Provider | GRUMBACH |
| First Name Of The Provider | KATHRYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 6804 |
| Number Of Medicare Beneficiaries | 2628 |
| Total Submitted Charge Amount | 527417.48 |
| Total Medicare Allowed Amount | 184328.87 |
| Total Medicare Payment Amount | 136052.4 |
| Total Medicare Standardized Payment Amount | 120395.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3270 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 4535.8 |
| Total Drug Medicare AllowedAmount | 592.2 |
| Total Drug Medicare PaymentAmount | 407.22 |
| Total Drug Medicare Standardized Payment Amount | 407.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3534 |
| Number Of Medicare Beneficiaries With Medical Services | 2628 |
| Total Medical Submitted Charge Amount | 522881.68 |
| Total Medical Medicare Allowed Amount | 183736.67 |
| Total Medical Medicare Payment Amount | 135645.18 |
| Total Medical Medicare Standardized Payment Amount | 119988.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 1064 |
| Number Of Beneficiaries Age 75 to 84 | 855 |
| Number Of Beneficiaries Age Greater 84 | 500 |
| Number Of Female Beneficiaries | 1498 |
| Number Of Male Beneficiaries | 1130 |
| Number Of Non Hispanic White Beneficiaries | 1825 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | 382 |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 494 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5147 |