| National Provider Identifier [NPI]: | 1134196686 |
| Last Name Of The Provider | GRANDE |
| First Name Of The Provider | DONALD |
| 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 | 92 MONTVALE AVE |
| Street Address 2 Of The Provider | SUITE 3000 |
| City Of The Provider | STONEHAM |
| Zip Code Of The Provider | 021803647 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 5829 |
| Number Of Medicare Beneficiaries | 1511 |
| Total Submitted Charge Amount | 2793975 |
| Total Medicare Allowed Amount | 1092207.43 |
| Total Medicare Payment Amount | 820126.48 |
| Total Medicare Standardized Payment Amount | 731045.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 12750 |
| Total Drug Medicare AllowedAmount | 12069.9 |
| Total Drug Medicare PaymentAmount | 8904.82 |
| Total Drug Medicare Standardized Payment Amount | 8904.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 5780 |
| Number Of Medicare Beneficiaries With Medical Services | 1511 |
| Total Medical Submitted Charge Amount | 2781225 |
| Total Medical Medicare Allowed Amount | 1080137.53 |
| Total Medical Medicare Payment Amount | 811221.66 |
| Total Medical Medicare Standardized Payment Amount | 722141.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 545 |
| Number Of Beneficiaries Age 75 to 84 | 504 |
| Number Of Beneficiaries Age Greater 84 | 356 |
| Number Of Female Beneficiaries | 813 |
| Number Of Male Beneficiaries | 698 |
| Number Of Non Hispanic White Beneficiaries | 1467 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1693 |