| National Provider Identifier [NPI]: | 1528132651 |
| Last Name Of The Provider | GRANGER |
| First Name Of The Provider | JAMIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3075 N RESERVE ST |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | MISSOULA |
| Zip Code Of The Provider | 598081389 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1423 |
| Number Of Medicare Beneficiaries | 335 |
| Total Submitted Charge Amount | 134959 |
| Total Medicare Allowed Amount | 54738.38 |
| Total Medicare Payment Amount | 38906.13 |
| Total Medicare Standardized Payment Amount | 45836.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 216 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 6651 |
| Total Drug Medicare AllowedAmount | 4309.28 |
| Total Drug Medicare PaymentAmount | 3996.82 |
| Total Drug Medicare Standardized Payment Amount | 3996.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1207 |
| Number Of Medicare Beneficiaries With Medical Services | 335 |
| Total Medical Submitted Charge Amount | 128308 |
| Total Medical Medicare Allowed Amount | 50429.1 |
| Total Medical Medicare Payment Amount | 34909.31 |
| Total Medical Medicare Standardized Payment Amount | 41839.57 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 92 |
| Number Of Non Hispanic White Beneficiaries | 323 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9916 |