| National Provider Identifier [NPI]: | 1972575694 |
| Last Name Of The Provider | GRISWOLD |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 103 BUSINESS HWY 54 NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELDON |
| Zip Code Of The Provider | 65026 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 5535 |
| Number Of Medicare Beneficiaries | 943 |
| Total Submitted Charge Amount | 359951.5 |
| Total Medicare Allowed Amount | 200693.86 |
| Total Medicare Payment Amount | 130290.4 |
| Total Medicare Standardized Payment Amount | 143270.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 699 |
| Number Of Medicare Beneficiaries With Drug Services | 289 |
| Total Drug Submitted ChargeAmount | 12956 |
| Total Drug Medicare AllowedAmount | 9180.03 |
| Total Drug Medicare PaymentAmount | 8823.12 |
| Total Drug Medicare Standardized Payment Amount | 8823.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 4836 |
| Number Of Medicare Beneficiaries With Medical Services | 943 |
| Total Medical Submitted Charge Amount | 346995.5 |
| Total Medical Medicare Allowed Amount | 191513.83 |
| Total Medical Medicare Payment Amount | 121467.28 |
| Total Medical Medicare Standardized Payment Amount | 134447.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 438 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 484 |
| Number Of Non Hispanic White Beneficiaries | 930 |
| 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 | 841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9616 |