| National Provider Identifier [NPI]: | 1689661704 |
| Last Name Of The Provider | GROSART |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 208 MILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRHAVEN |
| Zip Code Of The Provider | 027195208 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2212 |
| Number Of Medicare Beneficiaries | 566 |
| Total Submitted Charge Amount | 337350 |
| Total Medicare Allowed Amount | 144474.98 |
| Total Medicare Payment Amount | 101830.96 |
| Total Medicare Standardized Payment Amount | 99489.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 7908 |
| Total Drug Medicare AllowedAmount | 5670.18 |
| Total Drug Medicare PaymentAmount | 5522.58 |
| Total Drug Medicare Standardized Payment Amount | 5522.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1999 |
| Number Of Medicare Beneficiaries With Medical Services | 566 |
| Total Medical Submitted Charge Amount | 329442 |
| Total Medical Medicare Allowed Amount | 138804.8 |
| Total Medical Medicare Payment Amount | 96308.38 |
| Total Medical Medicare Standardized Payment Amount | 93966.79 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 162 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 240 |
| Number Of Non Hispanic White Beneficiaries | 522 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 480 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.118 |