| National Provider Identifier [NPI]: | 1598873382 |
| Last Name Of The Provider | GRAY |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5405 S 500 E STE 202 |
| Street Address 2 Of The Provider | |
| City Of The Provider | OGDEN |
| Zip Code Of The Provider | 844057419 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 526829 |
| Number Of Medicare Beneficiaries | 786 |
| Total Submitted Charge Amount | 10976984 |
| Total Medicare Allowed Amount | 6622701.24 |
| Total Medicare Payment Amount | 5140452.99 |
| Total Medicare Standardized Payment Amount | 5154027.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 68 |
| Number Of Drug Services | 510967 |
| Number Of Medicare Beneficiaries With Drug Services | 342 |
| Total Drug Submitted ChargeAmount | 8631606 |
| Total Drug Medicare AllowedAmount | 5690368.32 |
| Total Drug Medicare PaymentAmount | 4423368.53 |
| Total Drug Medicare Standardized Payment Amount | 4423368.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 15862 |
| Number Of Medicare Beneficiaries With Medical Services | 786 |
| Total Medical Submitted Charge Amount | 2345378 |
| Total Medical Medicare Allowed Amount | 932332.92 |
| Total Medical Medicare Payment Amount | 717084.46 |
| Total Medical Medicare Standardized Payment Amount | 730658.49 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 302 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 475 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 704 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 739 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.6979 |