| National Provider Identifier [NPI]: | 1073671442 |
| Last Name Of The Provider | CHRISTIAN |
| First Name Of The Provider | GRANT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 425 MEDICAL DRIVE |
| Street Address 2 Of The Provider | SUITE 118 |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 84010 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1642 |
| Number Of Medicare Beneficiaries | 650 |
| Total Submitted Charge Amount | 137753.25 |
| Total Medicare Allowed Amount | 111359.44 |
| Total Medicare Payment Amount | 80805.12 |
| Total Medicare Standardized Payment Amount | 85786.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 2415 |
| Total Drug Medicare AllowedAmount | 1465.87 |
| Total Drug Medicare PaymentAmount | 1431.83 |
| Total Drug Medicare Standardized Payment Amount | 1431.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1545 |
| Number Of Medicare Beneficiaries With Medical Services | 650 |
| Total Medical Submitted Charge Amount | 135338.25 |
| Total Medical Medicare Allowed Amount | 109893.57 |
| Total Medical Medicare Payment Amount | 79373.29 |
| Total Medical Medicare Standardized Payment Amount | 84354.35 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 271 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 310 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.032 |