| National Provider Identifier [NPI]: | 1427061191 |
| Last Name Of The Provider | GRANT |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1307 8TH AVE STE 106 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761044141 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1524 |
| Number Of Medicare Beneficiaries | 359 |
| Total Submitted Charge Amount | 165162 |
| Total Medicare Allowed Amount | 76910.67 |
| Total Medicare Payment Amount | 53046.52 |
| Total Medicare Standardized Payment Amount | 54448.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 161 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 5233 |
| Total Drug Medicare AllowedAmount | 3077.27 |
| Total Drug Medicare PaymentAmount | 2991.24 |
| Total Drug Medicare Standardized Payment Amount | 2991.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1363 |
| Number Of Medicare Beneficiaries With Medical Services | 359 |
| Total Medical Submitted Charge Amount | 159929 |
| Total Medical Medicare Allowed Amount | 73833.4 |
| Total Medical Medicare Payment Amount | 50055.28 |
| Total Medical Medicare Standardized Payment Amount | 51457.53 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 241 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 190 |
| Number Of Black or African American Beneficiaries | 117 |
| 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 | 235 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8424 |