| National Provider Identifier [NPI]: | 1437590155 |
| Last Name Of The Provider | GRIGSBY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 JOHNNY MERCER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAVANNAH |
| Zip Code Of The Provider | 314102102 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 419 |
| Number Of Medicare Beneficiaries | 203 |
| Total Submitted Charge Amount | 16418.76 |
| Total Medicare Allowed Amount | 14540.69 |
| Total Medicare Payment Amount | 11081.71 |
| Total Medicare Standardized Payment Amount | 13184.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 145 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 3780.76 |
| Total Drug Medicare AllowedAmount | 3780.76 |
| Total Drug Medicare PaymentAmount | 3608.25 |
| Total Drug Medicare Standardized Payment Amount | 3608.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 274 |
| Number Of Medicare Beneficiaries With Medical Services | 203 |
| Total Medical Submitted Charge Amount | 12638 |
| Total Medical Medicare Allowed Amount | 10759.93 |
| Total Medical Medicare Payment Amount | 7473.46 |
| Total Medical Medicare Standardized Payment Amount | 9576.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7336 |