| National Provider Identifier [NPI]: | 1194762310 |
| Last Name Of The Provider | GRANT |
| First Name Of The Provider | SCOTT |
| 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 | 301 W BASTANCHURY RD |
| Street Address 2 Of The Provider | 285 |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928353419 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 6190 |
| Number Of Medicare Beneficiaries | 588 |
| Total Submitted Charge Amount | 2558436.48 |
| Total Medicare Allowed Amount | 1155296.8 |
| Total Medicare Payment Amount | 889023.06 |
| Total Medicare Standardized Payment Amount | 855198.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1706 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 1320140 |
| Total Drug Medicare AllowedAmount | 688613.59 |
| Total Drug Medicare PaymentAmount | 539475.52 |
| Total Drug Medicare Standardized Payment Amount | 539475.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 4484 |
| Number Of Medicare Beneficiaries With Medical Services | 588 |
| Total Medical Submitted Charge Amount | 1238296.48 |
| Total Medical Medicare Allowed Amount | 466683.21 |
| Total Medical Medicare Payment Amount | 349547.54 |
| Total Medical Medicare Standardized Payment Amount | 315722.76 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 345 |
| Number Of Male Beneficiaries | 243 |
| Number Of Non Hispanic White Beneficiaries | 460 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 512 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5282 |