| National Provider Identifier [NPI]: | 1376561720 |
| Last Name Of The Provider | GROSSETT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 6253 |
| Number Of Medicare Beneficiaries | 3497 |
| Total Submitted Charge Amount | 1289440 |
| Total Medicare Allowed Amount | 212673.69 |
| Total Medicare Payment Amount | 163520.12 |
| Total Medicare Standardized Payment Amount | 154947.54 |
| 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 | 147 |
| Number Of Medical Services | 6253 |
| Number Of Medicare Beneficiaries With Medical Services | 3497 |
| Total Medical Submitted Charge Amount | 1289440 |
| Total Medical Medicare Allowed Amount | 212673.69 |
| Total Medical Medicare Payment Amount | 163520.12 |
| Total Medical Medicare Standardized Payment Amount | 154947.54 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 711 |
| Number Of Beneficiaries Age 65 to 74 | 1197 |
| Number Of Beneficiaries Age 75 to 84 | 978 |
| Number Of Beneficiaries Age Greater 84 | 611 |
| Number Of Female Beneficiaries | 2187 |
| Number Of Male Beneficiaries | 1310 |
| Number Of Non Hispanic White Beneficiaries | 1422 |
| Number Of Black or African American Beneficiaries | 1906 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1299 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.1104 |