| National Provider Identifier [NPI]: | 1881673382 |
| Last Name Of The Provider | GRANBERG |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13131 TESSON FERRY RD |
| Street Address 2 Of The Provider | SUITE #105 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631283887 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 14526 |
| Number Of Medicare Beneficiaries | 597 |
| Total Submitted Charge Amount | 1986400.91 |
| Total Medicare Allowed Amount | 622395.37 |
| Total Medicare Payment Amount | 460366.61 |
| Total Medicare Standardized Payment Amount | 431608.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 10065 |
| Number Of Medicare Beneficiaries With Drug Services | 385 |
| Total Drug Submitted ChargeAmount | 48186.1 |
| Total Drug Medicare AllowedAmount | 10237.96 |
| Total Drug Medicare PaymentAmount | 7858.41 |
| Total Drug Medicare Standardized Payment Amount | 7858.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 4461 |
| Number Of Medicare Beneficiaries With Medical Services | 597 |
| Total Medical Submitted Charge Amount | 1938214.81 |
| Total Medical Medicare Allowed Amount | 612157.41 |
| Total Medical Medicare Payment Amount | 452508.2 |
| Total Medical Medicare Standardized Payment Amount | 423750.45 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 286 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 575 |
| 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 | 493 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2667 |