| National Provider Identifier [NPI]: | 1659373488 |
| Last Name Of The Provider | SCHMIDT |
| First Name Of The Provider | GRANT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 HOYT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVERETT |
| Zip Code Of The Provider | 982014918 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 418 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 44056.5 |
| Total Medicare Allowed Amount | 19320.03 |
| Total Medicare Payment Amount | 14373.68 |
| Total Medicare Standardized Payment Amount | 15169.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1215 |
| Total Drug Medicare AllowedAmount | 569.5 |
| Total Drug Medicare PaymentAmount | 548.69 |
| Total Drug Medicare Standardized Payment Amount | 548.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 365 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 42841.5 |
| Total Medical Medicare Allowed Amount | 18750.53 |
| Total Medical Medicare Payment Amount | 13824.99 |
| Total Medical Medicare Standardized Payment Amount | 14620.43 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 146 |
| 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 | 134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2205 |