| National Provider Identifier [NPI]: | 1952318388 |
| Last Name Of The Provider | GRANDON |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 131 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISBURG |
| Zip Code Of The Provider | 171011027 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1520 |
| Number Of Medicare Beneficiaries | 139 |
| Total Submitted Charge Amount | 82095 |
| Total Medicare Allowed Amount | 71953.94 |
| Total Medicare Payment Amount | 52432.95 |
| Total Medicare Standardized Payment Amount | 55438.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 1075 |
| Total Drug Medicare AllowedAmount | 1069.93 |
| Total Drug Medicare PaymentAmount | 1048.52 |
| Total Drug Medicare Standardized Payment Amount | 1048.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1468 |
| Number Of Medicare Beneficiaries With Medical Services | 139 |
| Total Medical Submitted Charge Amount | 81020 |
| Total Medical Medicare Allowed Amount | 70884.01 |
| Total Medical Medicare Payment Amount | 51384.43 |
| Total Medical Medicare Standardized Payment Amount | 54389.68 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 111 |
| 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 | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2828 |