Debra Lynn Grunden , NURSE
Nurse Practitioner • Terrell, TX
200 N Virginia St
Terrell, TX 751602732
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on March 26, 2010; this date does not establish years in practice.
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Published CMS data list 197 Original Medicare Part B services in 2020.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020. Published rows only; this is not a quality measure.
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Published Part B service records, 2020:
- 99214 — Established patient outpatient office visit: 88 service units.
- 36415 — Insertion of needle into vein for collection of blood sample: 46 service units.
- 87804 — Detection test by immunoassay with direct visual observation for influenza virus: 28 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2019 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2020). CPT notice
See all 5 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 681 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Atorvastatin Calcium — 102 prescription fills, including refills.
- Lisinopril — 73 prescription fills, including refills.
- Metformin Hcl — 50 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 25 records in the table · Guide: How to read Medicare Part D prescriber data
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More Part D prescriptions than 65% of clinicians listed under Nurse Practitioner in Texas (2024, 2,095 clinicians with data). Median for this group: 274. Middle half: 77 to 1,097.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 914 in 2017 to 197 in 2020.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017–2020.
Practice Location & Contact Primary Location
200 N Virginia St
Terrell, TX 751602732
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Community Health Service Agency, Inc.. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
2009
What Public CMS Data Show
Nurse Practitioner: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $11,157 in 2020
The total amount Medicare approved for these services in 2020. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020.
Paid by Medicare
About $6,036 in 2020
The part of the Medicare-allowed amount that Medicare itself paid in 2020, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020.
30-day fills
1,476 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$14,800 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $73.92 across 4 records.
By nature of payment
- Food and Beverage: $73.92 across 4 records.
Reporting-company totals (3 largest of 4)
- Lundbeck LLC: $31.86 across 1 record.
- Cranial Technologies, Inc: $16.84 across 1 record.
- Exact Sciences Corporation: $15.22 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
17 years (graduated 2009)
CMS Doctors and Clinicians data list 2009 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2010
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Debra Grunden has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Debra Grunden as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Terrell and Texas
Billing and prescribing volume is not a quality rating.
Medicare Part D prescriptions
More Part D prescriptions than 65% of clinicians listed under Nurse Practitioner in Texas (2024, 2,095 clinicians with data). Median for this group: 274. Middle half: 77 to 1,097.
Too few clinicians listed under Nurse Practitioner in Terrell have Medicare Part D data for 2024 to compare.
Part D drug cost
Close to the middle for clinicians listed under Nurse Practitioner in Texas (2024, 2,095 clinicians with data). Median for this group: $12,936. Middle half: $998 to $118,416.
Too few clinicians listed under Nurse Practitioner in Terrell have Medicare Part D data for 2024 to compare.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Debra Grunden are from 2020.
2 active clinicians are listed under Nurse Practitioner with a practice address in Terrell, TX (4,835 in Texas).
Addresses are self-reported to NPPES and may be out of date.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 78% from 914 in 2017 to 197 in 2020.
- 2017: 914
- 2018: 935
- 2019: 820
- 2020: 197
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Medicare-allowed amount
Medicare-allowed amount decreased 72% from $40,122 in 2017 to $11,157 in 2020.
- 2017: $40,122
- 2018: $43,335
- 2019: $40,441
- 2020: $11,157
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Paid by Medicare
Paid by Medicare decreased 78% from $27,587 in 2017 to $6,036 in 2020.
- 2017: $27,587
- 2018: $29,300
- 2019: $27,181
- 2020: $6,036
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 29% from 526 in 2018 to 681 in 2024.
- 2018: 526
- 2019: 675
- 2020: 278
- 2023: 126
- 2024: 681
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30-day fills
30-day fills increased 40% from 1,056 in 2018 to 1,476 in 2024.
- 2018: 1,056
- 2019: 1,250
- 2020: 591
- 2023: 273
- 2024: 1,476
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Part D drug cost
Part D drug cost increased 108% from $7,099 in 2018 to $14,800 in 2024.
- 2018: $7,099
- 2019: $8,666
- 2020: $3,173
- 2023: $14,060
- 2024: $14,800
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $50.30 in 2023 to $73.92 in 2025.
- 2023: $50.30
- 2024: $32.80
- 2025: $73.92
Sources: CMS Medicare Physician & Other Practitioners (2020), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $73.92.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Lundbeck LLC |
Food and Beverage
Cash or cash equivalent
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VYEPTI | General | $31.86 |
| Cranial Technologies, Inc |
Food and Beverage
Cash or cash equivalent
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Doc Band | General | $16.84 |
| Exact Sciences Corporation |
Food and Beverage
In-kind items and services
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Cologuard Collection Kit | General | $15.22 |
| VivaQuant Inc, dba Rhythm Express |
Food and Beverage
Cash or cash equivalent
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RHYTHM EXPRESS | General | $10.00 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2019 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2020; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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88 | 73 | $170.00 | $90.63 |
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36415
Insertion of needle into vein for collection of blood sample
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46 | 44 | $17.00 | $2.96 |
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87804
Detection test by immunoassay with direct visual observation for influenza virus
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28 | 14 | $60.00 | $16.22 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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23 | 23 | $105.00 | $62.32 |
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G0439
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
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12 | 12 | $160.00 | $96.45 |
Source: CMS Part B by Provider and Service, 2020; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Atorvastatin Calcium | Atorvastatin Calcium | 102 | 7,675 | $458.80 | 38 |
| Lisinopril | Lisinopril | 73 | 4,470 | $375.40 | 22 |
| Metformin Hcl | Metformin Hcl | 50 | 3,500 | $212.04 | 22 |
| Amlodipine Besylate | Amlodipine Besylate | 49 | 4,050 | $293.86 | 22 |
| Losartan Potassium | Losartan Potassium | 35 | 2,730 | $194.31 | 16 |
| Omeprazole | Omeprazole | 32 | 1,740 | $517.41 | 13 |
| Gabapentin | Gabapentin | 30 | 1,710 | $650.28 | 11 |
| Hydrochlorothiazide | Hydrochlorothiazide | 30 | 2,700 | $161.10 | 15 |
| Pregabalin | Pregabalin | 23 | 750 | $333.79 | — |
| Levothyroxine Sodium | Levothyroxine Sodium | 22 | 1,800 | $545.98 | 12 |
| Montelukast Sodium | Montelukast Sodium | 22 | 1,260 | $147.38 | — |
| Metoprolol Succinate | Metoprolol Succinate | 21 | 1,410 | $114.64 | — |
| Metoprolol Tartrate | Metoprolol Tartrate | 20 | 1,320 | $79.79 | — |
| Fluticasone Propionate | Fluticasone Propionate | 19 | 1,050 | $434.72 | — |
| Simvastatin | Simvastatin | 18 | 1,440 | $110.19 | — |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 18 | 375 | $523.53 | — |
| Clopidogrel | Clopidogrel Bisulfate | 17 | 1,290 | $44.34 | — |
| Lisinopril-Hydrochlorothiazide | Lisinopril/Hydrochlorothiazide | 16 | 780 | $94.42 | — |
| Potassium Chloride | Potassium Chloride | 14 | 840 | $128.63 | — |
| Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 13 | 370 | $131.64 | — |
| Carvedilol | Carvedilol | 12 | 660 | $26.10 | — |
| Escitalopram Oxalate | Escitalopram Oxalate | 12 | 540 | $57.68 | — |
| Allopurinol | Allopurinol | 11 | 630 | $27.97 | — |
| Humalog | Insulin Lispro | 11 | 387 | $961.22 | — |
| Trelegy Ellipta | Fluticasone/Umeclidin/Vilanter | 11 | 390 | $8,174.96 | — |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 363L00000X
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - NURSE PRACTITIONER
I20130311000448
TX
1052566452
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Community Health Service Agency, Inc.
2600 Commerce Way, Kaufman, TX 751427325
Phone: 9727503177
Community Health Service Agency, Inc.
91 W Side Sq, Cooper, TX 754321725
Phone: 9033950586
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Family Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner - Adult Health
Master of Science in Nursing, GNP
Nurse Practitioner - Adult Health
Master of Science in Nursing
Nurse Practitioner - Adult Health
Family Medicine
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated March 26, 2010.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Mailing Address
200 N Virginia St
Terrell, TX 751602732
Phone: 9725517500