| National Provider Identifier [NPI]: | 1710900568 |
| Last Name Of The Provider | GROATHOUSE |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2655 W 9000 S |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST JORDAN |
| Zip Code Of The Provider | 840888542 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 692 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 58939 |
| Total Medicare Allowed Amount | 40490.43 |
| Total Medicare Payment Amount | 25897.99 |
| Total Medicare Standardized Payment Amount | 28282.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 1632 |
| Total Drug Medicare AllowedAmount | 240.72 |
| Total Drug Medicare PaymentAmount | 171.17 |
| Total Drug Medicare Standardized Payment Amount | 171.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 575 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 57307 |
| Total Medical Medicare Allowed Amount | 40249.71 |
| Total Medical Medicare Payment Amount | 25726.82 |
| Total Medical Medicare Standardized Payment Amount | 28111.72 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 199 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | 308 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9654 |