| National Provider Identifier [NPI]: | 1205824174 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 HAWKINS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | IOWA CITY |
| Zip Code Of The Provider | 522421009 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 984 |
| Number Of Medicare Beneficiaries | 817 |
| Total Submitted Charge Amount | 359003 |
| Total Medicare Allowed Amount | 69764.9 |
| Total Medicare Payment Amount | 51957.4 |
| Total Medicare Standardized Payment Amount | 55166.62 |
| 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 | 48 |
| Number Of Medical Services | 984 |
| Number Of Medicare Beneficiaries With Medical Services | 817 |
| Total Medical Submitted Charge Amount | 359003 |
| Total Medical Medicare Allowed Amount | 69764.9 |
| Total Medical Medicare Payment Amount | 51957.4 |
| Total Medical Medicare Standardized Payment Amount | 55166.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 188 |
| Number Of Beneficiaries Age 65 to 74 | 351 |
| Number Of Beneficiaries Age 75 to 84 | 225 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 393 |
| Number Of Non Hispanic White Beneficiaries | 764 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.865 |