| National Provider Identifier [NPI]: | 1316957764 |
| Last Name Of The Provider | GRAMP |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 KING OF PRUSSIA RD |
| Street Address 2 Of The Provider | 3RD FLOOR |
| City Of The Provider | RADNOR |
| Zip Code Of The Provider | 190875235 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 3906 |
| Number Of Medicare Beneficiaries | 2428 |
| Total Submitted Charge Amount | 660649 |
| Total Medicare Allowed Amount | 209394.93 |
| Total Medicare Payment Amount | 164691.86 |
| Total Medicare Standardized Payment Amount | 157919.03 |
| 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 | 138 |
| Number Of Medical Services | 3906 |
| Number Of Medicare Beneficiaries With Medical Services | 2428 |
| Total Medical Submitted Charge Amount | 660649 |
| Total Medical Medicare Allowed Amount | 209394.93 |
| Total Medical Medicare Payment Amount | 164691.86 |
| Total Medical Medicare Standardized Payment Amount | 157919.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 249 |
| Number Of Beneficiaries Age 65 to 74 | 1033 |
| Number Of Beneficiaries Age 75 to 84 | 708 |
| Number Of Beneficiaries Age Greater 84 | 438 |
| Number Of Female Beneficiaries | 1568 |
| Number Of Male Beneficiaries | 860 |
| Number Of Non Hispanic White Beneficiaries | 2151 |
| Number Of Black or African American Beneficiaries | 161 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 349 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.4902 |