| National Provider Identifier [NPI]: | 1437295151 |
| Last Name Of The Provider | GROSS |
| First Name Of The Provider | STACY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 SOUTH BEDFORD ROAD |
| Street Address 2 Of The Provider | MOUNT KISCO MEDICAL GROUP PC |
| City Of The Provider | MOUNT KISCO |
| Zip Code Of The Provider | 10549 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1696 |
| Number Of Medicare Beneficiaries | 616 |
| Total Submitted Charge Amount | 131920.44 |
| Total Medicare Allowed Amount | 128088.94 |
| Total Medicare Payment Amount | 94363.13 |
| Total Medicare Standardized Payment Amount | 82858.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 443 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 11513.91 |
| Total Drug Medicare AllowedAmount | 11512.23 |
| Total Drug Medicare PaymentAmount | 9045.06 |
| Total Drug Medicare Standardized Payment Amount | 9045.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1253 |
| Number Of Medicare Beneficiaries With Medical Services | 616 |
| Total Medical Submitted Charge Amount | 120406.53 |
| Total Medical Medicare Allowed Amount | 116576.71 |
| Total Medical Medicare Payment Amount | 85318.07 |
| Total Medical Medicare Standardized Payment Amount | 73813.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 559 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0624 |