| National Provider Identifier [NPI]: | 1467492496 |
| Last Name Of The Provider | GROSS |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2975 BOBCAT VILLAGE CENTER RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | NORTH PORT |
| Zip Code Of The Provider | 342884600 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 2813 |
| Number Of Medicare Beneficiaries | 494 |
| Total Submitted Charge Amount | 247025 |
| Total Medicare Allowed Amount | 146725.36 |
| Total Medicare Payment Amount | 100123.03 |
| Total Medicare Standardized Payment Amount | 100581.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 198 |
| Number Of Medicare Beneficiaries With Drug Services | 179 |
| Total Drug Submitted ChargeAmount | 3370 |
| Total Drug Medicare AllowedAmount | 1607.61 |
| Total Drug Medicare PaymentAmount | 1530.41 |
| Total Drug Medicare Standardized Payment Amount | 1530.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2615 |
| Number Of Medicare Beneficiaries With Medical Services | 494 |
| Total Medical Submitted Charge Amount | 243655 |
| Total Medical Medicare Allowed Amount | 145117.75 |
| Total Medical Medicare Payment Amount | 98592.62 |
| Total Medical Medicare Standardized Payment Amount | 99051.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 224 |
| Number Of Non Hispanic White Beneficiaries | 477 |
| Number Of Black or African American Beneficiaries | |
| 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 | 483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9058 |