| National Provider Identifier [NPI]: | 1912093501 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | STACY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8 RICHLAND MEDICAL PARK DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 292038005 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 4786 |
| Number Of Medicare Beneficiaries | 1204 |
| Total Submitted Charge Amount | 766174.49 |
| Total Medicare Allowed Amount | 352540.78 |
| Total Medicare Payment Amount | 263434.84 |
| Total Medicare Standardized Payment Amount | 281096.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 466 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 16906 |
| Total Drug Medicare AllowedAmount | 11076.77 |
| Total Drug Medicare PaymentAmount | 8683.7 |
| Total Drug Medicare Standardized Payment Amount | 8683.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 4320 |
| Number Of Medicare Beneficiaries With Medical Services | 1204 |
| Total Medical Submitted Charge Amount | 749268.49 |
| Total Medical Medicare Allowed Amount | 341464.01 |
| Total Medical Medicare Payment Amount | 254751.14 |
| Total Medical Medicare Standardized Payment Amount | 272412.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 218 |
| Number Of Beneficiaries Age 65 to 74 | 460 |
| Number Of Beneficiaries Age 75 to 84 | 362 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 646 |
| Number Of Male Beneficiaries | 558 |
| Number Of Non Hispanic White Beneficiaries | 801 |
| Number Of Black or African American Beneficiaries | 380 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 915 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8308 |