| National Provider Identifier [NPI]: | 1326085671 |
| Last Name Of The Provider | GRIGOROPOULOS |
| First Name Of The Provider | JERRY |
| 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 | 1524 MCHENRY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953504500 |
| 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 | 134 |
| Number Of Services | 5672 |
| Number Of Medicare Beneficiaries | 2552 |
| Total Submitted Charge Amount | 504689.62 |
| Total Medicare Allowed Amount | 107865.92 |
| Total Medicare Payment Amount | 79586.22 |
| Total Medicare Standardized Payment Amount | 77596.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1507 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1648 |
| Total Drug Medicare AllowedAmount | 291.27 |
| Total Drug Medicare PaymentAmount | 228.31 |
| Total Drug Medicare Standardized Payment Amount | 228.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 4165 |
| Number Of Medicare Beneficiaries With Medical Services | 2552 |
| Total Medical Submitted Charge Amount | 503041.62 |
| Total Medical Medicare Allowed Amount | 107574.65 |
| Total Medical Medicare Payment Amount | 79357.91 |
| Total Medical Medicare Standardized Payment Amount | 77368.06 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 871 |
| Number Of Beneficiaries Age 75 to 84 | 689 |
| Number Of Beneficiaries Age Greater 84 | 402 |
| Number Of Female Beneficiaries | 1377 |
| Number Of Male Beneficiaries | 1175 |
| Number Of Non Hispanic White Beneficiaries | 1702 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | 129 |
| Number Of Hispanic Beneficiaries | 597 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1162 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1390 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.007 |