| National Provider Identifier [NPI]: | 1073597753 |
| Last Name Of The Provider | GRAYSON |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 116 MIMOSA DR |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | THOMASVILLE |
| Zip Code Of The Provider | 317926605 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 4184 |
| Number Of Medicare Beneficiaries | 790 |
| Total Submitted Charge Amount | 759349 |
| Total Medicare Allowed Amount | 251194.6 |
| Total Medicare Payment Amount | 190465.05 |
| Total Medicare Standardized Payment Amount | 199299.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 112800 |
| Total Drug Medicare AllowedAmount | 30730 |
| Total Drug Medicare PaymentAmount | 23601.49 |
| Total Drug Medicare Standardized Payment Amount | 23601.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 4043 |
| Number Of Medicare Beneficiaries With Medical Services | 790 |
| Total Medical Submitted Charge Amount | 646549 |
| Total Medical Medicare Allowed Amount | 220464.6 |
| Total Medical Medicare Payment Amount | 166863.56 |
| Total Medical Medicare Standardized Payment Amount | 175697.67 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 223 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 572 |
| Number Of Black or African American Beneficiaries | 205 |
| 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 | 587 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3772 |