| National Provider Identifier [NPI]: | 1396752770 |
| Last Name Of The Provider | GRANT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5424 DISCOVERY PARK BLVD |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | WILLIAMSBURG |
| Zip Code Of The Provider | 231882904 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 3823 |
| Number Of Medicare Beneficiaries | 314 |
| Total Submitted Charge Amount | 447251 |
| Total Medicare Allowed Amount | 135922.74 |
| Total Medicare Payment Amount | 100121.28 |
| Total Medicare Standardized Payment Amount | 102887.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2241 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 26892 |
| Total Drug Medicare AllowedAmount | 3987.56 |
| Total Drug Medicare PaymentAmount | 3085.04 |
| Total Drug Medicare Standardized Payment Amount | 3085.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 1582 |
| Number Of Medicare Beneficiaries With Medical Services | 314 |
| Total Medical Submitted Charge Amount | 420359 |
| Total Medical Medicare Allowed Amount | 131935.18 |
| Total Medical Medicare Payment Amount | 97036.24 |
| Total Medical Medicare Standardized Payment Amount | 99802.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 261 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8708 |