| National Provider Identifier [NPI]: | 1407853674 |
| Last Name Of The Provider | GRASTY |
| First Name Of The Provider | BETTY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 TUSCAN STE 235 |
| Street Address 2 Of The Provider | |
| City Of The Provider | IRVING |
| Zip Code Of The Provider | 750393839 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 609 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 68655 |
| Total Medicare Allowed Amount | 48184.07 |
| Total Medicare Payment Amount | 33958.55 |
| Total Medicare Standardized Payment Amount | 34574.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 2965 |
| Total Drug Medicare AllowedAmount | 1508.93 |
| Total Drug Medicare PaymentAmount | 1387.84 |
| Total Drug Medicare Standardized Payment Amount | 1387.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 544 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 65690 |
| Total Medical Medicare Allowed Amount | 46675.14 |
| Total Medical Medicare Payment Amount | 32570.71 |
| Total Medical Medicare Standardized Payment Amount | 33186.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.859 |