| National Provider Identifier [NPI]: | 1699779462 |
| Last Name Of The Provider | GRIMSLEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 SHIRCLIFF WAY STE 300 |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322044753 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 3825 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 956520 |
| Total Medicare Allowed Amount | 332579.12 |
| Total Medicare Payment Amount | 249026.2 |
| Total Medicare Standardized Payment Amount | 248662.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1428 |
| Number Of Medicare Beneficiaries With Drug Services | 192 |
| Total Drug Submitted ChargeAmount | 36395 |
| Total Drug Medicare AllowedAmount | 24548.21 |
| Total Drug Medicare PaymentAmount | 18564.18 |
| Total Drug Medicare Standardized Payment Amount | 18564.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 2397 |
| Number Of Medicare Beneficiaries With Medical Services | 582 |
| Total Medical Submitted Charge Amount | 920125 |
| Total Medical Medicare Allowed Amount | 308030.91 |
| Total Medical Medicare Payment Amount | 230462.02 |
| Total Medical Medicare Standardized Payment Amount | 230098.61 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 461 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 451 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5105 |