| National Provider Identifier [NPI]: | 1720250319 |
| Last Name Of The Provider | GRANDBOIS |
| First Name Of The Provider | LINDSEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12368 STRATFORD DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | CLIVE |
| Zip Code Of The Provider | 503258162 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 9493 |
| Number Of Medicare Beneficiaries | 2835 |
| Total Submitted Charge Amount | 484295.5 |
| Total Medicare Allowed Amount | 196939.41 |
| Total Medicare Payment Amount | 174119.17 |
| Total Medicare Standardized Payment Amount | 191554.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5082 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 2693.5 |
| Total Drug Medicare AllowedAmount | 928.89 |
| Total Drug Medicare PaymentAmount | 728.29 |
| Total Drug Medicare Standardized Payment Amount | 728.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 4411 |
| Number Of Medicare Beneficiaries With Medical Services | 2835 |
| Total Medical Submitted Charge Amount | 481602 |
| Total Medical Medicare Allowed Amount | 196010.52 |
| Total Medical Medicare Payment Amount | 173390.88 |
| Total Medical Medicare Standardized Payment Amount | 190826.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 351 |
| Number Of Beneficiaries Age 65 to 74 | 1354 |
| Number Of Beneficiaries Age 75 to 84 | 796 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 2269 |
| Number Of Male Beneficiaries | 566 |
| Number Of Non Hispanic White Beneficiaries | 2679 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2421 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 414 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0127 |