| National Provider Identifier [NPI]: | 1346269586 |
| Last Name Of The Provider | GRENTZ |
| First Name Of The Provider | DIETMAR |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 102 S 3RD ST |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | CARSON CITY |
| Zip Code Of The Provider | 488115115 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 9186 |
| Number Of Medicare Beneficiaries | 2520 |
| Total Submitted Charge Amount | 566884.69 |
| Total Medicare Allowed Amount | 524920.73 |
| Total Medicare Payment Amount | 371551.47 |
| Total Medicare Standardized Payment Amount | 381228.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 11652.21 |
| Total Drug Medicare AllowedAmount | 11570.35 |
| Total Drug Medicare PaymentAmount | 8611.58 |
| Total Drug Medicare Standardized Payment Amount | 8611.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 9128 |
| Number Of Medicare Beneficiaries With Medical Services | 2520 |
| Total Medical Submitted Charge Amount | 555232.48 |
| Total Medical Medicare Allowed Amount | 513350.38 |
| Total Medical Medicare Payment Amount | 362939.89 |
| Total Medical Medicare Standardized Payment Amount | 372617.37 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 938 |
| Number Of Beneficiaries Age 75 to 84 | 972 |
| Number Of Beneficiaries Age Greater 84 | 469 |
| Number Of Female Beneficiaries | 1225 |
| Number Of Male Beneficiaries | 1295 |
| Number Of Non Hispanic White Beneficiaries | 2462 |
| Number Of Black or African American Beneficiaries | 22 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1358 |