| National Provider Identifier [NPI]: | 1770657132 |
| Last Name Of The Provider | WRAY |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | HWY 160 163 BUILDING KA2010 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KAYENTA |
| Zip Code Of The Provider | 860330368 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 580 |
| Number Of Medicare Beneficiaries | 330 |
| Total Submitted Charge Amount | 180968 |
| Total Medicare Allowed Amount | 31597.12 |
| Total Medicare Payment Amount | 23700.52 |
| Total Medicare Standardized Payment Amount | 24022.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 580 |
| Number Of Medicare Beneficiaries With Medical Services | 330 |
| Total Medical Submitted Charge Amount | 180968 |
| Total Medical Medicare Allowed Amount | 31597.12 |
| Total Medical Medicare Payment Amount | 23700.52 |
| Total Medical Medicare Standardized Payment Amount | 24022.51 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 128 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 239 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 22 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3245 |