| National Provider Identifier [NPI]: | 1952357188 |
| Last Name Of The Provider | GROSS |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12550 HESPERIA RD |
| Street Address 2 Of The Provider | 400 |
| City Of The Provider | VICTORVILLE |
| Zip Code Of The Provider | 923955873 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 36068 |
| Number Of Medicare Beneficiaries | 2961 |
| Total Submitted Charge Amount | 2873328 |
| Total Medicare Allowed Amount | 1823025.07 |
| Total Medicare Payment Amount | 1357791.47 |
| Total Medicare Standardized Payment Amount | 1231593.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 816 |
| Total Drug Medicare AllowedAmount | 60.4 |
| Total Drug Medicare PaymentAmount | 46.33 |
| Total Drug Medicare Standardized Payment Amount | 46.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 36034 |
| Number Of Medicare Beneficiaries With Medical Services | 2961 |
| Total Medical Submitted Charge Amount | 2872512 |
| Total Medical Medicare Allowed Amount | 1822964.67 |
| Total Medical Medicare Payment Amount | 1357745.14 |
| Total Medical Medicare Standardized Payment Amount | 1231546.82 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 1295 |
| Number Of Beneficiaries Age 75 to 84 | 1139 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1442 |
| Number Of Male Beneficiaries | 1519 |
| Number Of Non Hispanic White Beneficiaries | 2706 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2729 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 232 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0337 |