| National Provider Identifier [NPI]: | 1699751404 |
| Last Name Of The Provider | GROWCOCK |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR STE 600 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295907 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 25630 |
| Number Of Medicare Beneficiaries | 3557 |
| Total Submitted Charge Amount | 1562459.7 |
| Total Medicare Allowed Amount | 470986.96 |
| Total Medicare Payment Amount | 368444.93 |
| Total Medicare Standardized Payment Amount | 388677.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20478 |
| Number Of Medicare Beneficiaries With Drug Services | 226 |
| Total Drug Submitted ChargeAmount | 12871.5 |
| Total Drug Medicare AllowedAmount | 5258.44 |
| Total Drug Medicare PaymentAmount | 3957.11 |
| Total Drug Medicare Standardized Payment Amount | 3957.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 5152 |
| Number Of Medicare Beneficiaries With Medical Services | 3556 |
| Total Medical Submitted Charge Amount | 1549588.2 |
| Total Medical Medicare Allowed Amount | 465728.52 |
| Total Medical Medicare Payment Amount | 364487.82 |
| Total Medical Medicare Standardized Payment Amount | 384720.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 648 |
| Number Of Beneficiaries Age 65 to 74 | 1328 |
| Number Of Beneficiaries Age 75 to 84 | 1029 |
| Number Of Beneficiaries Age Greater 84 | 552 |
| Number Of Female Beneficiaries | 2175 |
| Number Of Male Beneficiaries | 1382 |
| Number Of Non Hispanic White Beneficiaries | 2068 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1217 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2629 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 928 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0229 |