National Provider Identifier [NPI]: |
1356310817 |
Last Name Of The Provider |
GRYTE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9055 SPRINGBROOK DR NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
COON RAPIDS |
Zip Code Of The Provider |
554335841 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
1168 |
Number Of Medicare Beneficiaries |
197 |
Total Submitted Charge Amount |
90314 |
Total Medicare Allowed Amount |
38305.91 |
Total Medicare Payment Amount |
29174.62 |
Total Medicare Standardized Payment Amount |
29581.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
82 |
Number Of Medicare Beneficiaries With Drug Services |
64 |
Total Drug Submitted ChargeAmount |
2923 |
Total Drug Medicare AllowedAmount |
1465.51 |
Total Drug Medicare PaymentAmount |
1320.4 |
Total Drug Medicare Standardized Payment Amount |
1320.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
1086 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
87391 |
Total Medical Medicare Allowed Amount |
36840.4 |
Total Medical Medicare Payment Amount |
27854.22 |
Total Medical Medicare Standardized Payment Amount |
28261.03 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1303 |