| National Provider Identifier [NPI]: | 1245286012 |
| Last Name Of The Provider | GRIMES |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 496 LYNNFIELD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LYNN |
| Zip Code Of The Provider | 01904 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 4291 |
| Number Of Medicare Beneficiaries | 641 |
| Total Submitted Charge Amount | 823804 |
| Total Medicare Allowed Amount | 250514.2 |
| Total Medicare Payment Amount | 184207.38 |
| Total Medicare Standardized Payment Amount | 179860.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 627 |
| Number Of Medicare Beneficiaries With Drug Services | 317 |
| Total Drug Submitted ChargeAmount | 40422 |
| Total Drug Medicare AllowedAmount | 28852.31 |
| Total Drug Medicare PaymentAmount | 27969.68 |
| Total Drug Medicare Standardized Payment Amount | 27969.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3664 |
| Number Of Medicare Beneficiaries With Medical Services | 641 |
| Total Medical Submitted Charge Amount | 783382 |
| Total Medical Medicare Allowed Amount | 221661.89 |
| Total Medical Medicare Payment Amount | 156237.7 |
| Total Medical Medicare Standardized Payment Amount | 151890.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 285 |
| Number Of Male Beneficiaries | 356 |
| Number Of Non Hispanic White Beneficiaries | 608 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3375 |