| National Provider Identifier [NPI]: | 1184729998 |
| Last Name Of The Provider | GREDYSA |
| First Name Of The Provider | LESLAW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31 MAIN RD |
| Street Address 2 Of The Provider | SUITE 2 |
| 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 | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 2468 |
| Number Of Medicare Beneficiaries | 684 |
| Total Submitted Charge Amount | 810814.86 |
| Total Medicare Allowed Amount | 695215.61 |
| Total Medicare Payment Amount | 537523.74 |
| Total Medicare Standardized Payment Amount | 460607.33 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 615 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 593 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6358 |