| National Provider Identifier [NPI]: | 1770588873 |
| Last Name Of The Provider | GRAY |
| First Name Of The Provider | ARTHUR |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7 BLANCHARD CIR |
| Street Address 2 Of The Provider | STE 203 |
| City Of The Provider | WHEATON |
| Zip Code Of The Provider | 601892037 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1062 |
| Number Of Medicare Beneficiaries | 199 |
| Total Submitted Charge Amount | 108235 |
| Total Medicare Allowed Amount | 67057.15 |
| Total Medicare Payment Amount | 49396.08 |
| Total Medicare Standardized Payment Amount | 44696.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 3540 |
| Total Drug Medicare AllowedAmount | 1808.03 |
| Total Drug Medicare PaymentAmount | 1417.46 |
| Total Drug Medicare Standardized Payment Amount | 1417.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1019 |
| Number Of Medicare Beneficiaries With Medical Services | 199 |
| Total Medical Submitted Charge Amount | 104695 |
| Total Medical Medicare Allowed Amount | 65249.12 |
| Total Medical Medicare Payment Amount | 47978.62 |
| Total Medical Medicare Standardized Payment Amount | 43279.28 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 103 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.029 |