| National Provider Identifier [NPI]: | 1528040219 |
| Last Name Of The Provider | GRAM |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 E LAKE SHORE DR |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625213809 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 3795 |
| Number Of Medicare Beneficiaries | 1429 |
| Total Submitted Charge Amount | 2261528 |
| Total Medicare Allowed Amount | 411606.46 |
| Total Medicare Payment Amount | 313632.16 |
| Total Medicare Standardized Payment Amount | 323990.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3795 |
| Number Of Medicare Beneficiaries With Medical Services | 1429 |
| Total Medical Submitted Charge Amount | 2261528 |
| Total Medical Medicare Allowed Amount | 411606.46 |
| Total Medical Medicare Payment Amount | 313632.16 |
| Total Medical Medicare Standardized Payment Amount | 323990.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 487 |
| Number Of Beneficiaries Age 75 to 84 | 473 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 750 |
| Number Of Male Beneficiaries | 679 |
| Number Of Non Hispanic White Beneficiaries | 1269 |
| Number Of Black or African American Beneficiaries | 142 |
| 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 | 1132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 297 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0326 |