| National Provider Identifier [NPI]: | 1922048487 |
| Last Name Of The Provider | GRANDA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | HARPER PROFESSIONAL BLDG STE 917 |
| Street Address 2 Of The Provider | 4160 JOHN R |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 48201 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1323 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 112407 |
| Total Medicare Allowed Amount | 65113.73 |
| Total Medicare Payment Amount | 46139.99 |
| Total Medicare Standardized Payment Amount | 43765.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 616 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 3131 |
| Total Drug Medicare AllowedAmount | 1621.27 |
| Total Drug Medicare PaymentAmount | 1256.55 |
| Total Drug Medicare Standardized Payment Amount | 1256.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 707 |
| Number Of Medicare Beneficiaries With Medical Services | 291 |
| Total Medical Submitted Charge Amount | 109276 |
| Total Medical Medicare Allowed Amount | 63492.46 |
| Total Medical Medicare Payment Amount | 44883.44 |
| Total Medical Medicare Standardized Payment Amount | 42508.84 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 37 |
| Number Of Black or African American Beneficiaries | 240 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8793 |