| National Provider Identifier [NPI]: | 1659391704 |
| Last Name Of The Provider | GROVER |
| First Name Of The Provider | BRUCE |
| 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 | 589 SOUTH STATE STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | PROVO |
| Zip Code Of The Provider | 846065056 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 509 |
| Number Of Medicare Beneficiaries | 91 |
| Total Submitted Charge Amount | 10356 |
| Total Medicare Allowed Amount | 3387.61 |
| Total Medicare Payment Amount | 3291.76 |
| Total Medicare Standardized Payment Amount | 3462.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 864 |
| Total Drug Medicare AllowedAmount | 40.89 |
| Total Drug Medicare PaymentAmount | 11.84 |
| Total Drug Medicare Standardized Payment Amount | 11.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 451 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 9492 |
| Total Medical Medicare Allowed Amount | 3346.72 |
| Total Medical Medicare Payment Amount | 3279.92 |
| Total Medical Medicare Standardized Payment Amount | 3450.86 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| 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 | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 73 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0456 |