| National Provider Identifier [NPI]: | 1316902919 |
| Last Name Of The Provider | GROS |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 512 W BURLINGTON AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LA GRANGE |
| Zip Code Of The Provider | 605252221 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 5444 |
| Number Of Medicare Beneficiaries | 537 |
| Total Submitted Charge Amount | 638252 |
| Total Medicare Allowed Amount | 304802.38 |
| Total Medicare Payment Amount | 219723.2 |
| Total Medicare Standardized Payment Amount | 206587.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 383 |
| Number Of Medicare Beneficiaries With Drug Services | 263 |
| Total Drug Submitted ChargeAmount | 11452 |
| Total Drug Medicare AllowedAmount | 6532.37 |
| Total Drug Medicare PaymentAmount | 6323.6 |
| Total Drug Medicare Standardized Payment Amount | 6323.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 5061 |
| Number Of Medicare Beneficiaries With Medical Services | 537 |
| Total Medical Submitted Charge Amount | 626800 |
| Total Medical Medicare Allowed Amount | 298270.01 |
| Total Medical Medicare Payment Amount | 213399.6 |
| Total Medical Medicare Standardized Payment Amount | 200264.13 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 302 |
| Number Of Male Beneficiaries | 235 |
| Number Of Non Hispanic White Beneficiaries | 514 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 520 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1638 |