| National Provider Identifier [NPI]: | 1326123951 |
| Last Name Of The Provider | GRIMM |
| First Name Of The Provider | ALEXANDER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23845 MCBEAN PKWY |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | VALENCIA |
| Zip Code Of The Provider | 913552001 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 2826 |
| Number Of Medicare Beneficiaries | 1883 |
| Total Submitted Charge Amount | 556077 |
| Total Medicare Allowed Amount | 106986.29 |
| Total Medicare Payment Amount | 75936.73 |
| Total Medicare Standardized Payment Amount | 71822.09 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 292 |
| Number Of Beneficiaries Age 65 to 74 | 584 |
| Number Of Beneficiaries Age 75 to 84 | 603 |
| Number Of Beneficiaries Age Greater 84 | 404 |
| Number Of Female Beneficiaries | 1096 |
| Number Of Male Beneficiaries | 787 |
| Number Of Non Hispanic White Beneficiaries | 727 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | 164 |
| Number Of Hispanic Beneficiaries | 784 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1490 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.5167 |