| National Provider Identifier [NPI]: | 1205885910 |
| Last Name Of The Provider | GRAY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3308 FOSTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANGELO |
| Zip Code Of The Provider | 769039314 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 278 |
| Number Of Services | 9789 |
| Number Of Medicare Beneficiaries | 4183 |
| Total Submitted Charge Amount | 1169632 |
| Total Medicare Allowed Amount | 305993.7 |
| Total Medicare Payment Amount | 237634.63 |
| Total Medicare Standardized Payment Amount | 248233.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 278 |
| Number Of Medical Services | 9789 |
| Number Of Medicare Beneficiaries With Medical Services | 4183 |
| Total Medical Submitted Charge Amount | 1169632 |
| Total Medical Medicare Allowed Amount | 305993.7 |
| Total Medical Medicare Payment Amount | 237634.63 |
| Total Medical Medicare Standardized Payment Amount | 248233.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 688 |
| Number Of Beneficiaries Age 65 to 74 | 1628 |
| Number Of Beneficiaries Age 75 to 84 | 1271 |
| Number Of Beneficiaries Age Greater 84 | 596 |
| Number Of Female Beneficiaries | 2609 |
| Number Of Male Beneficiaries | 1574 |
| Number Of Non Hispanic White Beneficiaries | 3341 |
| Number Of Black or African American Beneficiaries | 97 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 706 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3098 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1085 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4881 |