| National Provider Identifier [NPI]: | 1295721876 |
| Last Name Of The Provider | GRAY |
| First Name Of The Provider | JANETTE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3636 FIFTH AVENUE |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 92103 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 3294 |
| Number Of Medicare Beneficiaries | 303 |
| Total Submitted Charge Amount | 420594.9 |
| Total Medicare Allowed Amount | 246773.78 |
| Total Medicare Payment Amount | 178969.16 |
| Total Medicare Standardized Payment Amount | 172640.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 402 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 17203 |
| Total Drug Medicare AllowedAmount | 2007.59 |
| Total Drug Medicare PaymentAmount | 1558.28 |
| Total Drug Medicare Standardized Payment Amount | 1558.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2892 |
| Number Of Medicare Beneficiaries With Medical Services | 303 |
| Total Medical Submitted Charge Amount | 403391.9 |
| Total Medical Medicare Allowed Amount | 244766.19 |
| Total Medical Medicare Payment Amount | 177410.88 |
| Total Medical Medicare Standardized Payment Amount | 171082.38 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 171 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 249 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9887 |