| National Provider Identifier [NPI]: | 1033191093 |
| Last Name Of The Provider | GROSSMAN |
| First Name Of The Provider | CLIFFORD |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 303 PARKWAY DRIVE NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 30312 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 261 |
| Number Of Services | 8745 |
| Number Of Medicare Beneficiaries | 1602 |
| Total Submitted Charge Amount | 1792204.59 |
| Total Medicare Allowed Amount | 523746.06 |
| Total Medicare Payment Amount | 407255.05 |
| Total Medicare Standardized Payment Amount | 406728.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5490 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 12110.59 |
| Total Drug Medicare AllowedAmount | 5054.24 |
| Total Drug Medicare PaymentAmount | 3962.49 |
| Total Drug Medicare Standardized Payment Amount | 3962.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 257 |
| Number Of Medical Services | 3255 |
| Number Of Medicare Beneficiaries With Medical Services | 1602 |
| Total Medical Submitted Charge Amount | 1780094 |
| Total Medical Medicare Allowed Amount | 518691.82 |
| Total Medical Medicare Payment Amount | 403292.56 |
| Total Medical Medicare Standardized Payment Amount | 402765.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 424 |
| Number Of Beneficiaries Age 65 to 74 | 586 |
| Number Of Beneficiaries Age 75 to 84 | 407 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 932 |
| Number Of Male Beneficiaries | 670 |
| Number Of Non Hispanic White Beneficiaries | 899 |
| Number Of Black or African American Beneficiaries | 635 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1106 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 496 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4946 |