| National Provider Identifier [NPI]: | 1497852206 |
| Last Name Of The Provider | GRIFFITH |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2650 RIDGE AVE |
| Street Address 2 Of The Provider | EMERGENCY MEDICINE, RM G909 |
| City Of The Provider | EVANSTON |
| Zip Code Of The Provider | 602011718 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 922 |
| Number Of Medicare Beneficiaries | 811 |
| Total Submitted Charge Amount | 374828 |
| Total Medicare Allowed Amount | 144979.8 |
| Total Medicare Payment Amount | 108046.84 |
| Total Medicare Standardized Payment Amount | 100529.97 |
| 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 | 26 |
| Number Of Medical Services | 922 |
| Number Of Medicare Beneficiaries With Medical Services | 811 |
| Total Medical Submitted Charge Amount | 374828 |
| Total Medical Medicare Allowed Amount | 144979.8 |
| Total Medical Medicare Payment Amount | 108046.84 |
| Total Medical Medicare Standardized Payment Amount | 100529.97 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 265 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 330 |
| Number Of Non Hispanic White Beneficiaries | 713 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8842 |