| National Provider Identifier [NPI]: | 1932179132 |
| Last Name Of The Provider | LONG |
| First Name Of The Provider | GRAHAM |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 525 E BIG BEAVER RD |
| Street Address 2 Of The Provider | SUITE 125 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480831364 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 2945 |
| Number Of Medicare Beneficiaries | 1669 |
| Total Submitted Charge Amount | 711954 |
| Total Medicare Allowed Amount | 365197.88 |
| Total Medicare Payment Amount | 280027.36 |
| Total Medicare Standardized Payment Amount | 264371.7 |
| 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 | 132 |
| Number Of Medical Services | 2945 |
| Number Of Medicare Beneficiaries With Medical Services | 1669 |
| Total Medical Submitted Charge Amount | 711954 |
| Total Medical Medicare Allowed Amount | 365197.88 |
| Total Medical Medicare Payment Amount | 280027.36 |
| Total Medical Medicare Standardized Payment Amount | 264371.7 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 215 |
| Number Of Beneficiaries Age 65 to 74 | 522 |
| Number Of Beneficiaries Age 75 to 84 | 558 |
| Number Of Beneficiaries Age Greater 84 | 374 |
| Number Of Female Beneficiaries | 907 |
| Number Of Male Beneficiaries | 762 |
| Number Of Non Hispanic White Beneficiaries | 1253 |
| Number Of Black or African American Beneficiaries | 349 |
| 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 | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 315 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.3124 |