| National Provider Identifier [NPI]: | 1104905942 |
| Last Name Of The Provider | GRANGAARD |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 424 W STATE HIGHWAY 5 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WACONIA |
| Zip Code Of The Provider | 553871723 |
| 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 | 87 |
| Number Of Services | 1077 |
| Number Of Medicare Beneficiaries | 116 |
| Total Submitted Charge Amount | 35016.4 |
| Total Medicare Allowed Amount | 30723.47 |
| Total Medicare Payment Amount | 23938.72 |
| Total Medicare Standardized Payment Amount | 24179.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 392 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 5534.52 |
| Total Drug Medicare AllowedAmount | 4387.64 |
| Total Drug Medicare PaymentAmount | 3579.86 |
| Total Drug Medicare Standardized Payment Amount | 3579.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 685 |
| Number Of Medicare Beneficiaries With Medical Services | 116 |
| Total Medical Submitted Charge Amount | 29481.88 |
| Total Medical Medicare Allowed Amount | 26335.83 |
| Total Medical Medicare Payment Amount | 20358.86 |
| Total Medical Medicare Standardized Payment Amount | 20600.03 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 66 |
| 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 | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 21 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0072 |