| National Provider Identifier [NPI]: | 1790795730 |
| Last Name Of The Provider | ROMO-GRITZEWSKY |
| First Name Of The Provider | MARYLOU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 268 GREEN VALLEY RD |
| Street Address 2 Of The Provider | BLDG 4 |
| City Of The Provider | FREEDOM |
| Zip Code Of The Provider | 950193139 |
| 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 | 57 |
| Number Of Services | 6890 |
| Number Of Medicare Beneficiaries | 666 |
| Total Submitted Charge Amount | 539190.9 |
| Total Medicare Allowed Amount | 361230 |
| Total Medicare Payment Amount | 269131.29 |
| Total Medicare Standardized Payment Amount | 261635.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 3132 |
| Number Of Medicare Beneficiaries With Drug Services | 246 |
| Total Drug Submitted ChargeAmount | 56306 |
| Total Drug Medicare AllowedAmount | 45738.29 |
| Total Drug Medicare PaymentAmount | 36672.56 |
| Total Drug Medicare Standardized Payment Amount | 36672.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 666 |
| Total Medical Submitted Charge Amount | 482884.9 |
| Total Medical Medicare Allowed Amount | 315491.71 |
| Total Medical Medicare Payment Amount | 232458.73 |
| Total Medical Medicare Standardized Payment Amount | 224962.58 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 407 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 310 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 335 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.563 |