| National Provider Identifier [NPI]: | 1154330389 |
| Last Name Of The Provider | ROGERO |
| First Name Of The Provider | GRANT |
| 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 | 1121 W VINE ST |
| Street Address 2 Of The Provider | SUITE 15 |
| City Of The Provider | LODI |
| Zip Code Of The Provider | 95240 |
| 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 | 202 |
| Number Of Services | 14467 |
| Number Of Medicare Beneficiaries | 5407 |
| Total Submitted Charge Amount | 2927127 |
| Total Medicare Allowed Amount | 727078.85 |
| Total Medicare Payment Amount | 584802.03 |
| Total Medicare Standardized Payment Amount | 561200.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1348 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 9436 |
| Total Drug Medicare AllowedAmount | 2654.79 |
| Total Drug Medicare PaymentAmount | 2081.44 |
| Total Drug Medicare Standardized Payment Amount | 2081.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 13119 |
| Number Of Medicare Beneficiaries With Medical Services | 5407 |
| Total Medical Submitted Charge Amount | 2917691 |
| Total Medical Medicare Allowed Amount | 724424.06 |
| Total Medical Medicare Payment Amount | 582720.59 |
| Total Medical Medicare Standardized Payment Amount | 559118.81 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 727 |
| Number Of Beneficiaries Age 65 to 74 | 2042 |
| Number Of Beneficiaries Age 75 to 84 | 1651 |
| Number Of Beneficiaries Age Greater 84 | 987 |
| Number Of Female Beneficiaries | 3572 |
| Number Of Male Beneficiaries | 1835 |
| Number Of Non Hispanic White Beneficiaries | 4381 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 234 |
| Number Of Hispanic Beneficiaries | 629 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 88 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1297 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3546 |