| National Provider Identifier [NPI]: | 1457559692 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1264 WEAVER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRANVILLE |
| Zip Code Of The Provider | 430231257 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1382 |
| Number Of Medicare Beneficiaries | 354 |
| Total Submitted Charge Amount | 89261 |
| Total Medicare Allowed Amount | 71529.57 |
| Total Medicare Payment Amount | 48264.76 |
| Total Medicare Standardized Payment Amount | 50461.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 176 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 4286 |
| Total Drug Medicare AllowedAmount | 2465.07 |
| Total Drug Medicare PaymentAmount | 2384.12 |
| Total Drug Medicare Standardized Payment Amount | 2384.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1206 |
| Number Of Medicare Beneficiaries With Medical Services | 354 |
| Total Medical Submitted Charge Amount | 84975 |
| Total Medical Medicare Allowed Amount | 69064.5 |
| Total Medical Medicare Payment Amount | 45880.64 |
| Total Medical Medicare Standardized Payment Amount | 48077.28 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 330 |
| Number Of Black or African American Beneficiaries | |
| 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 | 284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9853 |