| National Provider Identifier [NPI]: | 1790769594 |
| Last Name Of The Provider | GRIMSHAW |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 354 BIRNIE AVE |
| Street Address 2 Of The Provider | HAMPDEN COUNTY PHYSICIAN ASSOIATES SUITE 202 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071108 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 255 |
| Number Of Medicare Beneficiaries | 144 |
| Total Submitted Charge Amount | 33602 |
| Total Medicare Allowed Amount | 15377.6 |
| Total Medicare Payment Amount | 11919.15 |
| Total Medicare Standardized Payment Amount | 13801.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 255 |
| Number Of Medicare Beneficiaries With Medical Services | 144 |
| Total Medical Submitted Charge Amount | 33602 |
| Total Medical Medicare Allowed Amount | 15377.6 |
| Total Medical Medicare Payment Amount | 11919.15 |
| Total Medical Medicare Standardized Payment Amount | 13801.12 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 116 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 71 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 57 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6449 |