| National Provider Identifier [NPI]: | 1750355392 |
| Last Name Of The Provider | GROSSKLAUS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6007 E BASELINE RD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852064801 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 6649 |
| Number Of Medicare Beneficiaries | 1398 |
| Total Submitted Charge Amount | 1523894.19 |
| Total Medicare Allowed Amount | 665776.7 |
| Total Medicare Payment Amount | 497716.32 |
| Total Medicare Standardized Payment Amount | 506037.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 495 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 306424 |
| Total Drug Medicare AllowedAmount | 126808.94 |
| Total Drug Medicare PaymentAmount | 98072.46 |
| Total Drug Medicare Standardized Payment Amount | 98072.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 6154 |
| Number Of Medicare Beneficiaries With Medical Services | 1398 |
| Total Medical Submitted Charge Amount | 1217470.19 |
| Total Medical Medicare Allowed Amount | 538967.76 |
| Total Medical Medicare Payment Amount | 399643.86 |
| Total Medical Medicare Standardized Payment Amount | 407965.21 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 643 |
| Number Of Beneficiaries Age 75 to 84 | 520 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 276 |
| Number Of Male Beneficiaries | 1122 |
| Number Of Non Hispanic White Beneficiaries | 1303 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1931 |