| National Provider Identifier [NPI]: | 1972585990 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | TERRENCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DPM,FACFAS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 102 W KENWOOD AVE |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625264368 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3562 |
| Number Of Medicare Beneficiaries | 483 |
| Total Submitted Charge Amount | 200171.23 |
| Total Medicare Allowed Amount | 177043.4 |
| Total Medicare Payment Amount | 126212.13 |
| Total Medicare Standardized Payment Amount | 136681.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 278.86 |
| Total Drug Medicare AllowedAmount | 65.26 |
| Total Drug Medicare PaymentAmount | 46.01 |
| Total Drug Medicare Standardized Payment Amount | 46.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 3496 |
| Number Of Medicare Beneficiaries With Medical Services | 483 |
| Total Medical Submitted Charge Amount | 199892.37 |
| Total Medical Medicare Allowed Amount | 176978.14 |
| Total Medical Medicare Payment Amount | 126166.12 |
| Total Medical Medicare Standardized Payment Amount | 136635.81 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 197 |
| Number Of Non Hispanic White Beneficiaries | 451 |
| Number Of Black or African American Beneficiaries | |
| 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 | 429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2899 |