| National Provider Identifier [NPI]: | 1992733109 |
| Last Name Of The Provider | GRAY |
| First Name Of The Provider | GLENN |
| 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 | 375 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 12 |
| City Of The Provider | BAY SHORE |
| Zip Code Of The Provider | 117068418 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 19401 |
| Number Of Medicare Beneficiaries | 3409 |
| Total Submitted Charge Amount | 3304507.25 |
| Total Medicare Allowed Amount | 1312999.71 |
| Total Medicare Payment Amount | 1007384.56 |
| Total Medicare Standardized Payment Amount | 919153.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 14295 |
| Number Of Medicare Beneficiaries With Drug Services | 491 |
| Total Drug Submitted ChargeAmount | 76140.8 |
| Total Drug Medicare AllowedAmount | 6188.58 |
| Total Drug Medicare PaymentAmount | 4842.69 |
| Total Drug Medicare Standardized Payment Amount | 4842.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 192 |
| Number Of Medical Services | 5106 |
| Number Of Medicare Beneficiaries With Medical Services | 3391 |
| Total Medical Submitted Charge Amount | 3228366.45 |
| Total Medical Medicare Allowed Amount | 1306811.13 |
| Total Medical Medicare Payment Amount | 1002541.87 |
| Total Medical Medicare Standardized Payment Amount | 914310.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 387 |
| Number Of Beneficiaries Age 65 to 74 | 1422 |
| Number Of Beneficiaries Age 75 to 84 | 1195 |
| Number Of Beneficiaries Age Greater 84 | 405 |
| Number Of Female Beneficiaries | 2034 |
| Number Of Male Beneficiaries | 1375 |
| Number Of Non Hispanic White Beneficiaries | 2899 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 246 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 72 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2946 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 463 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2565 |