| National Provider Identifier [NPI]: | 1093856833 |
| Last Name Of The Provider | GRILLO |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 52 WASHINGTON AVE |
| Street Address 2 Of The Provider | SUITE 4 |
| City Of The Provider | NORTH HAVEN |
| Zip Code Of The Provider | 064731724 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 732 |
| Number Of Medicare Beneficiaries | 169 |
| Total Submitted Charge Amount | 80416 |
| Total Medicare Allowed Amount | 38839.33 |
| Total Medicare Payment Amount | 27907.23 |
| Total Medicare Standardized Payment Amount | 31656.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2226 |
| Total Drug Medicare AllowedAmount | 439.01 |
| Total Drug Medicare PaymentAmount | 365.87 |
| Total Drug Medicare Standardized Payment Amount | 365.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 650 |
| Number Of Medicare Beneficiaries With Medical Services | 169 |
| Total Medical Submitted Charge Amount | 78190 |
| Total Medical Medicare Allowed Amount | 38400.32 |
| Total Medical Medicare Payment Amount | 27541.36 |
| Total Medical Medicare Standardized Payment Amount | 31290.95 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 148 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 99 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2925 |