National Provider Identifier [NPI]: |
1043276934 |
Last Name Of The Provider |
GRISIER |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
537 W 18TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ERIE |
Zip Code Of The Provider |
165021722 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
4618 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
360070 |
Total Medicare Allowed Amount |
261744.22 |
Total Medicare Payment Amount |
201449.92 |
Total Medicare Standardized Payment Amount |
165824.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
1282 |
Total Drug Medicare AllowedAmount |
422.2 |
Total Drug Medicare PaymentAmount |
411.6 |
Total Drug Medicare Standardized Payment Amount |
411.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
4576 |
Number Of Medicare Beneficiaries With Medical Services |
604 |
Total Medical Submitted Charge Amount |
358788 |
Total Medical Medicare Allowed Amount |
261322.02 |
Total Medical Medicare Payment Amount |
201038.32 |
Total Medical Medicare Standardized Payment Amount |
165412.68 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
217 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
303 |
Number Of Non Hispanic White Beneficiaries |
546 |
Number Of Black or African American Beneficiaries |
39 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
288 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.8737 |