| National Provider Identifier [NPI]: | 1811008162 |
| Last Name Of The Provider | GRANOVSKY |
| First Name Of The Provider | SABRA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 ALHAMBRA BLVD |
| Street Address 2 Of The Provider | #230 |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958165238 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1080 |
| Number Of Medicare Beneficiaries | 222 |
| Total Submitted Charge Amount | 276258 |
| Total Medicare Allowed Amount | 95355.25 |
| Total Medicare Payment Amount | 69583.17 |
| Total Medicare Standardized Payment Amount | 67554.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 140 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 10268 |
| Total Drug Medicare AllowedAmount | 6571.18 |
| Total Drug Medicare PaymentAmount | 6436.25 |
| Total Drug Medicare Standardized Payment Amount | 6436.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 222 |
| Total Medical Submitted Charge Amount | 265990 |
| Total Medical Medicare Allowed Amount | 88784.07 |
| Total Medical Medicare Payment Amount | 63146.92 |
| Total Medical Medicare Standardized Payment Amount | 61118.28 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0141 |