| National Provider Identifier [NPI]: | 1134132830 |
| Last Name Of The Provider | GROSS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1333 ROANOKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERHEAD |
| Zip Code Of The Provider | 11901 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 7979 |
| Number Of Medicare Beneficiaries | 3189 |
| Total Submitted Charge Amount | 1191551.67 |
| Total Medicare Allowed Amount | 439911.48 |
| Total Medicare Payment Amount | 342564.2 |
| Total Medicare Standardized Payment Amount | 295517.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2976 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 5952 |
| Total Drug Medicare AllowedAmount | 561.25 |
| Total Drug Medicare PaymentAmount | 433.23 |
| Total Drug Medicare Standardized Payment Amount | 433.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 5003 |
| Number Of Medicare Beneficiaries With Medical Services | 3188 |
| Total Medical Submitted Charge Amount | 1185599.67 |
| Total Medical Medicare Allowed Amount | 439350.23 |
| Total Medical Medicare Payment Amount | 342130.97 |
| Total Medical Medicare Standardized Payment Amount | 295084.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 350 |
| Number Of Beneficiaries Age 65 to 74 | 1288 |
| Number Of Beneficiaries Age 75 to 84 | 1023 |
| Number Of Beneficiaries Age Greater 84 | 528 |
| Number Of Female Beneficiaries | 1943 |
| Number Of Male Beneficiaries | 1246 |
| Number Of Non Hispanic White Beneficiaries | 2638 |
| Number Of Black or African American Beneficiaries | 161 |
| Number Of AsianPacific Islander Beneficiaries | 216 |
| Number Of Hispanic Beneficiaries | 110 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2570 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 619 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2801 |