| National Provider Identifier [NPI]: | 1730348970 |
| Last Name Of The Provider | GRUSD |
| First Name Of The Provider | BRANDON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D., J.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10666 N TORREY PINES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371027 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 5538 |
| Number Of Medicare Beneficiaries | 1826 |
| Total Submitted Charge Amount | 621957.85 |
| Total Medicare Allowed Amount | 177950.99 |
| Total Medicare Payment Amount | 131598.23 |
| Total Medicare Standardized Payment Amount | 131772.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2743 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 6226.6 |
| Total Drug Medicare AllowedAmount | 2248.51 |
| Total Drug Medicare PaymentAmount | 1694.01 |
| Total Drug Medicare Standardized Payment Amount | 1694.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 204 |
| Number Of Medical Services | 2795 |
| Number Of Medicare Beneficiaries With Medical Services | 1826 |
| Total Medical Submitted Charge Amount | 615731.25 |
| Total Medical Medicare Allowed Amount | 175702.48 |
| Total Medical Medicare Payment Amount | 129904.22 |
| Total Medical Medicare Standardized Payment Amount | 130078.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 793 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 314 |
| Number Of Female Beneficiaries | 964 |
| Number Of Male Beneficiaries | 862 |
| Number Of Non Hispanic White Beneficiaries | 1471 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 113 |
| Number Of Hispanic Beneficiaries | 156 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6532 |