| National Provider Identifier [NPI]: | 1114928967 |
| Last Name Of The Provider | GRINBERG |
| First Name Of The Provider | MANUEL |
| 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 | 250 YAPHANK RD |
| Street Address 2 Of The Provider | STE 11B |
| City Of The Provider | EAST PATCHOGUE |
| Zip Code Of The Provider | 117724800 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 3914 |
| Number Of Medicare Beneficiaries | 1213 |
| Total Submitted Charge Amount | 1268313.81 |
| Total Medicare Allowed Amount | 378026.39 |
| Total Medicare Payment Amount | 285894.96 |
| Total Medicare Standardized Payment Amount | 254703.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 390 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 96588.72 |
| Total Drug Medicare AllowedAmount | 34316.62 |
| Total Drug Medicare PaymentAmount | 26659.9 |
| Total Drug Medicare Standardized Payment Amount | 26659.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 3524 |
| Number Of Medicare Beneficiaries With Medical Services | 1213 |
| Total Medical Submitted Charge Amount | 1171725.09 |
| Total Medical Medicare Allowed Amount | 343709.77 |
| Total Medical Medicare Payment Amount | 259235.06 |
| Total Medical Medicare Standardized Payment Amount | 228043.56 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 459 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 342 |
| Number Of Male Beneficiaries | 871 |
| Number Of Non Hispanic White Beneficiaries | 1063 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 938 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 275 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7081 |