| National Provider Identifier [NPI]: | 1205004652 |
| Last Name Of The Provider | GROSSMAN |
| First Name Of The Provider | IRWIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 SOLAR DR STE 135 |
| Street Address 2 Of The Provider | |
| City Of The Provider | OXNARD |
| Zip Code Of The Provider | 930360635 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 4330 |
| Number Of Medicare Beneficiaries | 2594 |
| Total Submitted Charge Amount | 3340735.55 |
| Total Medicare Allowed Amount | 755069.3 |
| Total Medicare Payment Amount | 570781.38 |
| Total Medicare Standardized Payment Amount | 508665.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 423 |
| Number Of Medicare Beneficiaries With Drug Services | 399 |
| Total Drug Submitted ChargeAmount | 44178.9 |
| Total Drug Medicare AllowedAmount | 667.96 |
| Total Drug Medicare PaymentAmount | 522.05 |
| Total Drug Medicare Standardized Payment Amount | 522.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 3907 |
| Number Of Medicare Beneficiaries With Medical Services | 2594 |
| Total Medical Submitted Charge Amount | 3296556.65 |
| Total Medical Medicare Allowed Amount | 754401.34 |
| Total Medical Medicare Payment Amount | 570259.33 |
| Total Medical Medicare Standardized Payment Amount | 508143.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 1196 |
| Number Of Beneficiaries Age 75 to 84 | 742 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 1643 |
| Number Of Male Beneficiaries | 951 |
| Number Of Non Hispanic White Beneficiaries | 1831 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 84 |
| Number Of Hispanic Beneficiaries | 575 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2028 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1495 |