National Provider Identifier [NPI]: |
1770518656 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
ROLAND |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4802 10TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKLYN |
Zip Code Of The Provider |
112192916 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
475 |
Number Of Medicare Beneficiaries |
391 |
Total Submitted Charge Amount |
807117.2 |
Total Medicare Allowed Amount |
96835.65 |
Total Medicare Payment Amount |
74901.69 |
Total Medicare Standardized Payment Amount |
65720.27 |
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 |
47 |
Number Of Medical Services |
475 |
Number Of Medicare Beneficiaries With Medical Services |
391 |
Total Medical Submitted Charge Amount |
807117.2 |
Total Medical Medicare Allowed Amount |
96835.65 |
Total Medical Medicare Payment Amount |
74901.69 |
Total Medical Medicare Standardized Payment Amount |
65720.27 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
265 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
27 |
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5529 |